Provider Demographics
NPI:1811355704
Name:JOHNSON, LAUREN (LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:JOHNSON
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 1:9 COVEY RD
Mailing Address - Street 2:SUITE 2AF
Mailing Address - City:BURLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06013-1720
Mailing Address - Country:US
Mailing Address - Phone:860-259-4441
Mailing Address - Fax:
Practice Address - Street 1:9 COVEY RD
Practice Address - Street 2:SUITE 2AF
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1720
Practice Address - Country:US
Practice Address - Phone:860-259-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional