Provider Demographics
NPI:1568145142
Name:GONZALEZ, LAUREN ALLISON (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ALLISON
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S EATON ST UNIT 2049
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4369
Mailing Address - Country:US
Mailing Address - Phone:410-660-7885
Mailing Address - Fax:
Practice Address - Street 1:1700 UNION AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1499
Practice Address - Country:US
Practice Address - Phone:443-386-0931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical