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 503010
Mailing Address - Street 2:
Mailing Address - City:WHITE CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97503-0813
Mailing Address - Country:US
Mailing Address - Phone:541-234-4781
Mailing Address - Fax:541-479-4010
Practice Address - Street 1:777 NE 7TH ST STE 205
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1632
Practice Address - Country:US
Practice Address - Phone:541-507-6400
Practice Address - Fax:541-479-4010
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health