Provider Demographics
NPI:1841461696
Name:CLEMENTS, LAUREN NICOLE (LCSW-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 SEFTON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2300
Mailing Address - Country:US
Mailing Address - Phone:443-642-2052
Mailing Address - Fax:
Practice Address - Street 1:5609 SEFTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2300
Practice Address - Country:US
Practice Address - Phone:443-642-2052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical