Provider Demographics
NPI:1588221097
Name:LAUREN WORLEY, LICENSED CLINICAL SOCIAL WORKER CORPORATION
Entity Type:Organization
Organization Name:LAUREN WORLEY, LICENSED CLINICAL SOCIAL WORKER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-314-7477
Mailing Address - Street 1:2626 FOOTHILL BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3574
Mailing Address - Country:US
Mailing Address - Phone:626-314-7477
Mailing Address - Fax:
Practice Address - Street 1:2626 FOOTHILL BLVD STE 208
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3574
Practice Address - Country:US
Practice Address - Phone:626-314-7477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty