Provider Demographics
NPI:1689150393
Name:HANSEN, LAUREN BYRD (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BYRD
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ASHLEY
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4136 PHILWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38122-3913
Mailing Address - Country:US
Mailing Address - Phone:901-246-0538
Mailing Address - Fax:
Practice Address - Street 1:4136 PHILWOOD AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-3913
Practice Address - Country:US
Practice Address - Phone:901-246-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000065301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical