MEDICARE: LAUREN STANLEY

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	101YM0800X	Mental Health Counselor	95244	TX
2	101YP2500X	Professional Counselor	95244	TX
3	101Y00000X	Counselor	95244	TX

General Provider Information

NPI Number	:	1942042759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN STANLEY

Provider Business Mailing Address
First Line	:	5870 HIGHWAY 6 N STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5870 HIGHWAY 6 N STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-1850
Country	:	US
Telephone Number	:	346-516-4196
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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Directions to “ LAUREN STANLEY ” Practice Location

Language	Start Address	Practice Location

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