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NPI Code Detail

MEDICARE: LAUREN K. STANFORD

MEDICARE: LAUREN K. STANFORD
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1710759824
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN K. STANFORD
Provider Business Mailing Address
First Line : 6982 FILLMORE DR
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-3360
Country : US
Telephone Number : 219-299-5953
Fax Number :
Provider Business Practice Location Address
First Line : 2005 VALPARAISO ST STE 209
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-3331
Country : US
Telephone Number : 219-252-5464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2023
Last Update Date : 10/23/2023

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Directions to “ LAUREN K. STANFORD ” Practice Location

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