Provider Demographics
NPI:1720364284
Name:LE, LAUREN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 25TH AVE
Mailing Address - Street 2:206
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4947
Mailing Address - Country:US
Mailing Address - Phone:812-580-0194
Mailing Address - Fax:
Practice Address - Street 1:1770 25TH AVE 206
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4949
Practice Address - Country:US
Practice Address - Phone:970-373-4602
Practice Address - Fax:800-854-6944
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC008006104100000X, 101Y00000X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health