Healthcare Provider Details

I. General information

NPI: 1548191034
Provider Name (Legal Business Name): MRS. LAUREN HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 COMMON ST
LAKE CHARLES LA
70601-6131
US

IV. Provider business mailing address

8142 KELSEY LN
IOWA LA
70647-3973
US

V. Phone/Fax

Practice location:
  • Phone: 575-626-0027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: