Healthcare Provider Details
I. General information
NPI: 1285304980
Provider Name (Legal Business Name): LAUREN POWELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/15/2021
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 LINCOLN ST STE 203
FRAMINGHAM MA
01702-8264
US
IV. Provider business mailing address
61 LINCOLN ST STE 203
FRAMINGHAM MA
01702-8264
US
V. Phone/Fax
- Phone: 781-666-2711
- Fax: 781-666-2712
- Phone: 781-666-2711
- Fax: 781-666-2712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 227515 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 68665 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: