Provider Demographics
NPI:1477080513
Name:LAVENE, LAUREN (LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LAVENE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:WINGATE
Mailing Address - State:TX
Mailing Address - Zip Code:79566-0213
Mailing Address - Country:US
Mailing Address - Phone:469-975-5641
Mailing Address - Fax:
Practice Address - Street 1:318 CEDAR ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5722
Practice Address - Country:US
Practice Address - Phone:832-353-2927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-19
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72975101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health