Provider Demographics
NPI:1265917397
Name:COPPENS, LAUREN M (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:COPPENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BATHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1133 W MILL RD STE 211
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3806
Mailing Address - Country:US
Mailing Address - Phone:812-250-9255
Mailing Address - Fax:
Practice Address - Street 1:316 CHANDLER AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1147
Practice Address - Country:US
Practice Address - Phone:812-436-4501
Practice Address - Fax:812-436-4510
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008903A104100000X
IN34010256A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker