Provider Demographics
NPI:1942712534
Name:IMPRAIM, LAUREN M (LPC-18569)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:M
Last Name:IMPRAIM
Suffix:
Gender:F
Credentials:LPC-18569
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:M
Other - Last Name:GOLOMBEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:12714 E PAIGE CANYON LN
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-0109
Mailing Address - Country:US
Mailing Address - Phone:779-770-7693
Mailing Address - Fax:
Practice Address - Street 1:12714 E PAIGE CANYON LN
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-0109
Practice Address - Country:US
Practice Address - Phone:779-770-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-18569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional