Healthcare Provider Details

I. General information

NPI: 1225942493
Provider Name (Legal Business Name): LAUREN SCANLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 GIRARD ST
FLORENCE KY
41042-1664
US

IV. Provider business mailing address

31 GIRARD ST
FLORENCE KY
41042-1664
US

V. Phone/Fax

Practice location:
  • Phone: 310-619-8989
  • Fax:
Mailing address:
  • Phone: 310-619-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number311007
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: