Provider Demographics
NPI:1477110906
Name:MUIR, LAUREN (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:MUIR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:TOMLINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12615 WESTPORT RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-6448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1860 MELLWOOD AVE STE 117
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1033
Practice Address - Country:US
Practice Address - Phone:270-816-5068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164011101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional