Healthcare Provider Details

I. General information

NPI: 1043540560
Provider Name (Legal Business Name): LAUREN EVANS LMHC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN KENNEDY LMHC, LCMHC

II. Dates (important events)

Enumeration Date: 01/05/2010
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

250 PLEASANT ST
CONCORD NH
03301-7559
US

V. Phone/Fax

Practice location:
  • Phone: 631-559-6407
  • Fax:
Mailing address:
  • Phone: 603-228-7200
  • Fax: 603-227-7562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2121
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number004314
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: