Provider Demographics
NPI:1932455409
Name:IRIGOYEN, LAUREN (PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:IRIGOYEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:CAHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:64 ORLAND SQUARE DR STE 112
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6543
Mailing Address - Country:US
Mailing Address - Phone:630-522-3124
Mailing Address - Fax:
Practice Address - Street 1:64 ORLAND SQUARE DR STE 112
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6543
Practice Address - Country:US
Practice Address - Phone:630-522-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071010414103TC0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health