Healthcare Provider Details

I. General information

NPI: 1770914137
Provider Name (Legal Business Name): LAUREN PAULING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN BANKS M.A.

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 NITTANY VALLEY DR
MILL HALL PA
17751-8805
US

IV. Provider business mailing address

320 HIGHLAND DR PO BOX 597
MOUNTVILLE PA
17554-1232
US

V. Phone/Fax

Practice location:
  • Phone: 570-323-6944
  • Fax: 570-323-4529
Mailing address:
  • Phone: 570-323-6944
  • Fax: 570-323-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC009350
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: