Provider Demographics
NPI:1780018515
Name:GOMANCE, LAUREN (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GOMANCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-6847
Mailing Address - Country:US
Mailing Address - Phone:501-844-5554
Mailing Address - Fax:501-609-0166
Practice Address - Street 1:1820 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6847
Practice Address - Country:US
Practice Address - Phone:501-844-5554
Practice Address - Fax:501-609-0166
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA-1308080101YM0800X
ARP-1509098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health