Provider Demographics
NPI:1720087364
Name:PAYNE, LAUREN MURPHY (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MURPHY
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 DURAND AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5096
Mailing Address - Country:US
Mailing Address - Phone:262-554-0126
Mailing Address - Fax:262-554-0127
Practice Address - Street 1:6021 DURAND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-5096
Practice Address - Country:US
Practice Address - Phone:262-554-0126
Practice Address - Fax:262-554-0127
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI01791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical