Healthcare Provider Details

I. General information

NPI: 1972955714
Provider Name (Legal Business Name): LAUREN LEWIS MA, LPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN EAST

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E 29TH ST STE 237
LOVELAND CO
80538-2765
US

IV. Provider business mailing address

150 E 29TH ST STE 237
LOVELAND CO
80538-2765
US

V. Phone/Fax

Practice location:
  • Phone: 970-685-3937
  • Fax: 970-663-5601
Mailing address:
  • Phone: 970-685-3937
  • Fax: 970-663-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD0000980
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0013916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: