MEDICARE: LAUREN MURPHY PAYNE AND ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0179	WI

General Provider Information

NPI Number	:	1275667636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREN MURPHY PAYNE AND ASSOCIATES

Provider Business Mailing Address
First Line	:	3205 LAKEVIEW CIR
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53402-4007
Country	:	US
Telephone Number	:	262-639-4046
Fax Number	:

Provider Business Practice Location Address
First Line	:	6021 DURAND AVE
Second Line	:	SUITE 300
City	:	RACINE
State	:	WI
Zip	:	53406-5096
Country	:	US
Telephone Number	:	262-554-0126
Fax Number	:	262-554-0127

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN MURPHY PAYNE
Credential	:	LCSW
Telephone Number	:	262-554-0126

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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