Provider Demographics
NPI:1952820052
Name:MARX, LAUREN SOPHIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SOPHIE
Last Name:MARX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 PACES FERRY RD SE UNIT 502
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-7904
Mailing Address - Country:US
Mailing Address - Phone:678-360-2736
Mailing Address - Fax:
Practice Address - Street 1:2440 LAWRENCEVILLE HWY STE 200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3267
Practice Address - Country:US
Practice Address - Phone:404-692-3275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004134103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent