Provider Demographics
NPI:1912607680
Name:BRUCE, LAUREN BASS
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BASS
Last Name:BRUCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CHULA VISTA LN
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-6244
Mailing Address - Country:US
Mailing Address - Phone:205-616-9233
Mailing Address - Fax:
Practice Address - Street 1:151 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-4445
Practice Address - Country:US
Practice Address - Phone:205-941-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)