Provider Demographics
NPI:1679026793
Name:WICKS, LAUREN (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:WICKS
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 1:112 N 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201
Mailing Address - Country:US
Mailing Address - Phone:717-267-3000
Mailing Address - Fax:717-339-2711
Practice Address - Street 1:176 S COLDBROOK AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-267-7480
Practice Address - Fax:717-267-7403
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional