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General NPI Number Information
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NPI Number | 1093224024
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Entity Type | Individual
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Provider Name | LAUREN LEIGH BARRIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2501 CHATHAM RD STE N
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone | 616-328-6109
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Fax | 616-328-6529
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Provider Business Mailing Address
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Address Line | 625 KENMOOR AVE SE STE 301
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2395
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Country | US
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Telephone | 616-328-6109
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Fax | 616-328-6529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149022271
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License Number State | IL
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