Provider Demographics
NPI:1619722212
Name:BURGESS, LAUREN (MFT-T)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MFT-T
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SWINDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 FISHINGER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2103
Mailing Address - Country:US
Mailing Address - Phone:614-499-4398
Mailing Address - Fax:
Practice Address - Street 1:337 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3845
Practice Address - Country:US
Practice Address - Phone:740-365-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2400374-TRNE106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist