Provider Demographics
NPI:1689735078
Name:CARL, LAUREN PATRICIA (RI)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PATRICIA
Last Name:CARL
Suffix:
Gender:F
Credentials:RI
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:PATRICIA
Other - Last Name:GRANDINETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5427
Mailing Address - Country:US
Mailing Address - Phone:516-991-3005
Mailing Address - Fax:
Practice Address - Street 1:400 RESERVOIR AVE STE 2F
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-3565
Practice Address - Country:US
Practice Address - Phone:800-455-8726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health