Provider Demographics
NPI:1578109294
Name:APPLEGATE, LAUREN ASHLEY (LSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2549
Mailing Address - Country:US
Mailing Address - Phone:740-250-8989
Mailing Address - Fax:
Practice Address - Street 1:23030 STATE ROUTE 73
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-8861
Practice Address - Country:US
Practice Address - Phone:408-581-0637
Practice Address - Fax:740-858-9140
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1430095104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker