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General NPI Number Information
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NPI Number | 1124372651
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Entity Type | Individual
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Provider Name | LAUREN GERHARD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 228 E 45TH ST RM 9E
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City | NEW YORK
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State | NY
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Zip | 10017-3337
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Country | US
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Telephone | 212-812-8054
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Fax |
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Provider Business Mailing Address
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Address Line | 262 CRESTVIEW DR.
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City | COALVILLE
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State | UT
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Zip | 84017
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 84365386009
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License Number State | UT
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