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General NPI Number Information
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NPI Number | 1619226024
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Entity Type | Individual
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Provider Name | LAUREN HOGG LISW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 215 MILLER RD STE 7
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City | AVON LAKE
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State | OH
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Zip | 44012-1013
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Country | US
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Telephone | 440-742-1661
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Fax | 833-450-0400
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Provider Business Mailing Address
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Address Line | 2313 COUNTRY CLUB DR
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City | AVON
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State | OH
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Zip | 44011-5277
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Country | US
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Telephone | 216-672-8208
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | I.1901617
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License Number State | OH
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