Provider Demographics
NPI:1013705607
Name:LAUZEN, SKYLAR DIANE (BSW)
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:DIANE
Last Name:LAUZEN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 CHESHIRE LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-8514
Mailing Address - Country:US
Mailing Address - Phone:630-542-1336
Mailing Address - Fax:
Practice Address - Street 1:800 E GRAND AVE APT 30B
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-3506
Practice Address - Country:US
Practice Address - Phone:630-542-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker