Provider Demographics
NPI:1851867220
Name:BLOEMKER, LAUREN NICOLE (LISW-S)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:BLOEMKER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:HOSBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:2850 WINSLOW AVE.
Mailing Address - Street 2:MLC 9700
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206
Mailing Address - Country:US
Mailing Address - Phone:513-636-0225
Mailing Address - Fax:513-636-0661
Practice Address - Street 1:2850 WINSLOW AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1169
Practice Address - Country:US
Practice Address - Phone:513-636-0225
Practice Address - Fax:513-636-0661
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18012701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical