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General NPI Number Information
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NPI Number | 1730713868
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Entity Type | Individual
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Provider Name | LAUREN DELAPARTE PHD
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Gender | Female
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 11250 OLD SAINT AUGUSTINE RD STE 15-150
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1088
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Country | US
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Telephone | 904-201-9565
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Fax |
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Provider Business Mailing Address
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Address Line | 11250 OLD SAINT AUGUSTINE RD STE 15-150
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1088
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY0005320
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY11506
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License Number State | FL
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