Provider Demographics
NPI:1407321235
Name:KELLEY, LAUREN SWINGLE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:SWINGLE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 VAUXHALL DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4646
Mailing Address - Country:US
Mailing Address - Phone:615-343-6402
Mailing Address - Fax:615-875-1736
Practice Address - Street 1:1601 23RD AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3133
Practice Address - Country:US
Practice Address - Phone:615-343-6402
Practice Address - Fax:615-875-1736
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical