Provider Demographics
NPI:1962848564
Name:GROSSMAN, LAUREN ELIZABETH BARRETT (PSYD, MSED)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH BARRETT
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:PSYD, MSED
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:PO BOX 850
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:717-531-6491
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-6386
Practice Address - Fax:717-531-6491
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATPS030370103G00000X
CA28311103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist