Provider Demographics
NPI:1356078158
Name:WEST, LAUREN TRONCOSO (LMFT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:TRONCOSO
Last Name:WEST
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13444 GRAN BAY PKWY APT 720
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-7425
Mailing Address - Country:US
Mailing Address - Phone:954-707-1269
Mailing Address - Fax:
Practice Address - Street 1:1138 EDGEWOOD AVE S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-5369
Practice Address - Country:US
Practice Address - Phone:352-389-1920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4421106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist