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General NPI Number Information
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NPI Number | 1215432364
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Entity Type | Individual
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Provider Name | LAUREN LOUM
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Gender | Female
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 3111 S 70TH ST
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City | FORT SMITH
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State | AR
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Zip | 72903-5017
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Country | US
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Telephone | 479-452-6650
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Fax |
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Provider Business Mailing Address
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Address Line | 10301 MAYO DR
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City | BARLING
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State | AR
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Zip | 72923-1660
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A2206013
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P2406010
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License Number State | AR
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