Provider Demographics
NPI:1295176717
Name:KUNSTLER, LAUREN NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:KUNSTLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:HATCZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:230 LAKESIDE COURT
Mailing Address - Street 2:APT 1128
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:61074
Mailing Address - Country:US
Mailing Address - Phone:630-715-8665
Mailing Address - Fax:
Practice Address - Street 1:1831 BAY SCOTT CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1114
Practice Address - Country:US
Practice Address - Phone:630-305-0464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0156571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical