Provider Demographics
NPI:1578549655
Name:COMO, LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:COMO
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 1:333 LINCOLN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3113
Mailing Address - Country:US
Mailing Address - Phone:207-252-3223
Mailing Address - Fax:207-699-3831
Practice Address - Street 1:333 LINCOLN ST STE 205
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3113
Practice Address - Country:US
Practice Address - Phone:207-252-3223
Practice Address - Fax:207-699-3831
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC77031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME282400099Medicaid
MEMM9451Medicare PIN