Provider Demographics
NPI:1659807188
Name:HALL, LAUREN AMANDA (BS, CADC-U/S)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:AMANDA
Last Name:HALL
Suffix:
Gender:F
Credentials:BS, CADC-U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 S 28TH WEST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-7637
Mailing Address - Country:US
Mailing Address - Phone:918-902-7364
Mailing Address - Fax:
Practice Address - Street 1:5001 S 28TH WEST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74107-7637
Practice Address - Country:US
Practice Address - Phone:918-902-7364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)