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NPI Code Detail

MEDICARE: LAUREN A SPENCER

MEDICARE: LAUREN A SPENCER
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
1101YP2500XProfessional CounselorLPC013790GA
2101Y00000XCounselor

General Provider Information

NPI Number : 1760006175
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN A SPENCER
Provider Business Mailing Address
First Line : 644 OVERHILL DR
Second Line :
City : WOODSTOCK
State : GA
Zip : 30189-2573
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 738 WOODLAWN DR NE
Second Line :
City : MARIETTA
State : GA
Zip : 30068-4253
Country : US
Telephone Number : 770-726-9589
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2020
Last Update Date : 11/05/2023

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Directions to “ LAUREN A SPENCER ” Practice Location

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