Provider Demographics
NPI:1336264902
Name:LAUER, LUCY SIMPSON (LMHC)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:SIMPSON
Last Name:LAUER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2929
Mailing Address - Country:US
Mailing Address - Phone:321-327-3793
Mailing Address - Fax:321-327-7914
Practice Address - Street 1:107 N PALM AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-3131
Practice Address - Country:US
Practice Address - Phone:321-327-3793
Practice Address - Fax:321-327-7914
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health