Provider Demographics
NPI:1639958622
Name:KITTRELL, LAUREN CRAIN (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CRAIN
Last Name:KITTRELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LINDSEY HILL TRL
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:SC
Mailing Address - Zip Code:29661-9264
Mailing Address - Country:US
Mailing Address - Phone:864-356-6751
Mailing Address - Fax:
Practice Address - Street 1:6715 STATE PARK RD
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1831
Practice Address - Country:US
Practice Address - Phone:864-256-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health