Provider Demographics
NPI:1295482917
Name:MAGUIRE, LAUREN (LSW, MSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2293 VIREO DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-6453
Mailing Address - Country:US
Mailing Address - Phone:570-982-4617
Mailing Address - Fax:
Practice Address - Street 1:200 HOMEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4328
Practice Address - Country:US
Practice Address - Phone:937-733-6783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1390961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical