Provider Demographics
NPI:1922523752
Name:MORFORD, LAUREN MCCOY (ACSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MCCOY
Last Name:MORFORD
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 VERMONT ST APT 210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2149
Mailing Address - Country:US
Mailing Address - Phone:515-238-8977
Mailing Address - Fax:
Practice Address - Street 1:2397 SHATTUCK AVE STE 206
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1567
Practice Address - Country:US
Practice Address - Phone:515-238-8977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA781241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical