Provider Demographics
NPI:1770737363
Name:DAMBROS, LAUREN GRACE (CSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GRACE
Last Name:DAMBROS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ZORN AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1433
Mailing Address - Country:US
Mailing Address - Phone:502-287-4223
Mailing Address - Fax:502-287-6197
Practice Address - Street 1:800 ZORN AVE
Practice Address - Street 2:ROOM B-701
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1433
Practice Address - Country:US
Practice Address - Phone:502-287-4223
Practice Address - Fax:502-287-6197
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker