Healthcare Provider Details

I. General information

NPI: 1841646940
Provider Name (Legal Business Name): LAUREN A NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN A SMITH LCSW

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 N COLORADO ST
GILBERT AZ
85233
US

IV. Provider business mailing address

4747 N 7TH ST STE 100
PHOENIX AZ
85014
US

V. Phone/Fax

Practice location:
  • Phone: 480-820-0825
  • Fax: 480-820-7863
Mailing address:
  • Phone: 602-279-7655
  • Fax: 602-253-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23024
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: