Provider Demographics
NPI:1184972291
Name:STANLEY, LAUREN BOE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BOE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:MARY
Other - Last Name:BOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1221 E ELIZABETH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4066
Mailing Address - Country:US
Mailing Address - Phone:970-682-1337
Mailing Address - Fax:855-461-3393
Practice Address - Street 1:1221 E ELIZABETH ST STE 3
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4066
Practice Address - Country:US
Practice Address - Phone:970-682-1337
Practice Address - Fax:855-461-3393
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56538104100000X
CO099242741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker