Provider Demographics
NPI:1255606240
Name:FITCH, LAUREN E (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:FITCH
Suffix:
Gender:F
Credentials:LCSW
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 165
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-0165
Mailing Address - Country:US
Mailing Address - Phone:985-879-3966
Mailing Address - Fax:
Practice Address - Street 1:50 WADE ST
Practice Address - Street 2:SUITE 5
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-2051
Practice Address - Country:US
Practice Address - Phone:985-785-9300
Practice Address - Fax:985-785-9003
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA115661041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical