Provider Demographics
NPI:1770213431
Name:STORCK-BURGER, LAUREN D (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:STORCK-BURGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4748 SPRING SIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6731
Mailing Address - Country:US
Mailing Address - Phone:973-856-2611
Mailing Address - Fax:
Practice Address - Street 1:4748 SPRING SIDE DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6731
Practice Address - Country:US
Practice Address - Phone:973-856-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL200781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical