Provider Demographics
NPI:1023456795
Name:RICH, LAUREN WIEHLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:WIEHLE
Last Name:RICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:KAY
Other - Last Name:WIEHLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:928 N YORK ST STE 20
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-3118
Mailing Address - Country:US
Mailing Address - Phone:918-912-2266
Mailing Address - Fax:918-912-2267
Practice Address - Street 1:928 N YORK ST STE 20
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-3118
Practice Address - Country:US
Practice Address - Phone:918-912-2266
Practice Address - Fax:918-912-2267
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 1041C0700X, 104100000X
OK4613-P1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker