MEDICARE: MRS. LAUREN OLIVIA TREVATHAN L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	4351	TN

General Provider Information

NPI Number	:	1053514174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAUREN OLIVIA TREVATHAN L.C.S.W.

Provider Business Mailing Address
First Line	:	1300 LIPSCOMB DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7007
Country	:	US
Telephone Number	:	615-370-2441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 LIPSCOMB DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7007
Country	:	US
Telephone Number	:	615-828-4943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	06/24/2025

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