Provider Demographics
NPI:1770214520
Name:WAHBA, LAUREN (LISW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:WAHBA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1701 MERCY HEALTH PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-6147
Mailing Address - Country:US
Mailing Address - Phone:513-853-8520
Mailing Address - Fax:
Practice Address - Street 1:1701 MERCY HEALTH PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-6147
Practice Address - Country:US
Practice Address - Phone:513-853-8520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040145011041C0700X
OH21028341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical