Provider Demographics
NPI:1801463146
Name:ISAACSON, LAUREN ASHLEY (LMHC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:ISAACSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 N 900TH AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN CENTER
Mailing Address - State:IL
Mailing Address - Zip Code:61262-9571
Mailing Address - Country:US
Mailing Address - Phone:309-236-1336
Mailing Address - Fax:
Practice Address - Street 1:2550 MIDDLE RD STE 300
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3287
Practice Address - Country:US
Practice Address - Phone:309-236-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health