Healthcare Provider Details

I. General information

NPI: 1386584829
Provider Name (Legal Business Name): LAUREN SMITH PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 HINMAN AVE APT 3
EVANSTON IL
60202-5904
US

IV. Provider business mailing address

803 HINMAN AVE APT 3
EVANSTON IL
60202-5904
US

V. Phone/Fax

Practice location:
  • Phone: 414-737-4300
  • Fax:
Mailing address:
  • Phone: 414-737-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAUREN SMITH
Title or Position: OWNER
Credential: MA, LCPC
Phone: 414-737-4300