Provider Demographics
NPI:1356934376
Name:CORNEW, LAUREN (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:CORNEW
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 KENT RD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-3303
Mailing Address - Country:US
Mailing Address - Phone:858-692-4289
Mailing Address - Fax:
Practice Address - Street 1:209 KENT RD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-3303
Practice Address - Country:US
Practice Address - Phone:858-692-4289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0219871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical