Healthcare Provider Details

I. General information

NPI: 1144155219
Provider Name (Legal Business Name): LAUREN LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 FLINT RD
WILLIAMSTOWN VT
05679-9277
US

IV. Provider business mailing address

796 FLINT RD
WILLIAMSTOWN VT
05679-9277
US

V. Phone/Fax

Practice location:
  • Phone: 802-249-0755
  • Fax: 802-249-0755
Mailing address:
  • Phone: 802-249-0755
  • Fax: 802-249-0755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136961
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: