Provider Demographics
NPI:1851697528
Name:JOHNSON, LAUREN (LPC-S)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 E RICHARDSON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-3246
Mailing Address - Country:US
Mailing Address - Phone:501-278-1736
Mailing Address - Fax:501-214-6867
Practice Address - Street 1:125 1/2 N MARKET ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015
Practice Address - Country:US
Practice Address - Phone:662-727-1053
Practice Address - Fax:501-214-6867
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1410080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health