Provider Demographics
NPI:1669062725
Name:SMITH, LAUREN WHITNEY (PLADC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:WHITNEY
Last Name:SMITH
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8998 L ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1400
Mailing Address - Country:US
Mailing Address - Phone:402-881-0771
Mailing Address - Fax:402-500-3341
Practice Address - Street 1:8998 L ST STE 110
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1400
Practice Address - Country:US
Practice Address - Phone:402-881-0771
Practice Address - Fax:402-500-3341
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1643101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)