Healthcare Provider Details
I. General information
NPI: 1568765063
Provider Name (Legal Business Name): LAUREN NICHOLE SCHLUTERMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/06/2010
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 SALEM RD STE 1
CONWAY AR
72034-6166
US
IV. Provider business mailing address
2400 S 48TH ST
SPRINGDALE AR
72762-6683
US
V. Phone/Fax
- Phone: 501-336-8300
- Fax: 501-329-5508
- Phone: 479-725-5115
- Fax: 479-750-4843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | P1402025 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: