Healthcare Provider Details

I. General information

NPI: 1083433866
Provider Name (Legal Business Name): LAUREN SMITH MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 E COLORADO BLVD STE 180&2ND
PASADENA CA
91101-6143
US

IV. Provider business mailing address

4740 GREEN RIVER RD STE 110
CORONA CA
92878-9186
US

V. Phone/Fax

Practice location:
  • Phone: 949-607-7284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: