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General NPI Number Information
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NPI Number | 1700459062
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Entity Type | Individual
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Provider Name | LAUREN LANSRUD LMHC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 9777 TRANQUILITY LAKE CIR APT 403
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City | RIVERVIEW
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State | FL
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Zip | 33578-4053
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Country | US
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Telephone | 813-825-6911
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Fax |
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Provider Business Mailing Address
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Address Line | 9777 TRANQUILITY LAKE CIR APT 403
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City | RIVERVIEW
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State | FL
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Zip | 33578-4053
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Country | US
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Telephone | 813-825-6911
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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 | 068.0135048TELE
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13185741-6004
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | MH19386
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19386
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License Number State | FL
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