Healthcare Provider Details

I. General information

NPI: 1770152951
Provider Name (Legal Business Name): LAUREN NICOLE ORISCHAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3176 GUARDHOUSE CIR
VIRGINIA BEACH VA
23456-7510
US

IV. Provider business mailing address

6901 N CHARLES ST
TOWSON MD
21204-3711
US

V. Phone/Fax

Practice location:
  • Phone: 856-275-6811
  • Fax:
Mailing address:
  • Phone: 443-809-4130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number32618
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202010773
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12214
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: