Provider Demographics
NPI:1821356643
Name:EASLEY, LAUREN SCOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:SCOTT
Last Name:EASLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:SUZANNE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 LEGACY CIR
Mailing Address - Street 2:#414
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5680
Mailing Address - Country:US
Mailing Address - Phone:972-989-4890
Mailing Address - Fax:
Practice Address - Street 1:1099 MEDICAL CENTER DR STE 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7367
Practice Address - Country:US
Practice Address - Phone:919-445-0681
Practice Address - Fax:919-445-0691
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55384104100000X, 1041C0700X, 171M00000X
NCC0117931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator