Healthcare Provider Details

I. General information

NPI: 1265917397
Provider Name (Legal Business Name): LAUREN M COPPENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN BATHAUER

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CHANDLER AVE
EVANSVILLE IN
47713-1147
US

IV. Provider business mailing address

1133 W MILL RD STE 211
EVANSVILLE IN
47710-3806
US

V. Phone/Fax

Practice location:
  • Phone: 812-436-4501
  • Fax: 812-436-4510
Mailing address:
  • Phone: 812-250-9255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33008903A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010256A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: