Healthcare Provider Details

I. General information

NPI: 1194680785
Provider Name (Legal Business Name): LAUREN ATHERTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 CHEROKEE ST APT 2W
SAINT LOUIS MO
63118-3028
US

IV. Provider business mailing address

2835 CHEROKEE ST APT 2W
SAINT LOUIS MO
63118-3028
US

V. Phone/Fax

Practice location:
  • Phone: 314-202-1220
  • Fax:
Mailing address:
  • Phone: 314-202-1220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024024811
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: