Healthcare Provider Details

I. General information

NPI: 1376921015
Provider Name (Legal Business Name): LAUREN E GUSMAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN HAN

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 RAINBOW CT
FAIRBORN OH
45324-6365
US

IV. Provider business mailing address

PO BOX 933421
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3401
  • Fax: 937-641-3046
Mailing address:
  • Phone: 937-641-5072
  • Fax: 937-641-6129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE1800616
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: