Healthcare Provider Details

I. General information

NPI: 1770301251
Provider Name (Legal Business Name): LAUREN BUEHLER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 ANKEN ST
ROME NY
13440-2304
US

IV. Provider business mailing address

1608 ANKEN ST
ROME NY
13440-2304
US

V. Phone/Fax

Practice location:
  • Phone: 315-941-1947
  • Fax:
Mailing address:
  • Phone: 315-941-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number125016-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: