Provider Demographics
NPI:1013276757
Name:BELLENBAUM, LAUREN RENE (LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENE
Last Name:BELLENBAUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4365
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0168
Mailing Address - Country:US
Mailing Address - Phone:541-507-6400
Mailing Address - Fax:541-500-0112
Practice Address - Street 1:122 NE BEACON DR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3840
Practice Address - Country:US
Practice Address - Phone:541-507-6400
Practice Address - Fax:541-500-0112
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health