Provider Demographics
NPI:1831404482
Name:MOYER, LAUREN MICHAL (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHAL
Last Name:MOYER
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 1:1258 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3238
Mailing Address - Country:US
Mailing Address - Phone:541-342-8437
Mailing Address - Fax:541-242-2999
Practice Address - Street 1:3100 MARTIN LUTHER KING JR PKWY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-7514
Practice Address - Country:US
Practice Address - Phone:541-868-9700
Practice Address - Fax:541-485-7392
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL71611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical