Provider Demographics
NPI:1811411184
Name:STINSON, LAUREN LONG (MS, LAPC, NCC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LONG
Last Name:STINSON
Suffix:
Gender:F
Credentials:MS, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 COURTLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4902
Mailing Address - Country:US
Mailing Address - Phone:310-435-9268
Mailing Address - Fax:
Practice Address - Street 1:6 CONCOURSE PKWY STE 1650
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5325
Practice Address - Country:US
Practice Address - Phone:470-485-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health