Provider Demographics
NPI:1891097010
Name:HERRON, LAUREN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:HERRON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 KINGS MILL WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6186
Mailing Address - Country:US
Mailing Address - Phone:410-227-9426
Mailing Address - Fax:410-826-3736
Practice Address - Street 1:4631 KINGS MILL WAY
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6186
Practice Address - Country:US
Practice Address - Phone:410-227-9426
Practice Address - Fax:410-826-3736
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD158511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15851Medicaid