MEDICARE: DR. LAUREN C MENSIE PH.D.

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	103T00000X	Psychologist	200902435	MO

General Provider Information

NPI Number	:	1093049694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN C MENSIE PH.D.

Provider Business Mailing Address
First Line	:	12380 DE PAUL DR
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2511
Country	:	US
Telephone Number	:	314-447-9705
Fax Number	:	314-447-9706

Provider Business Practice Location Address
First Line	:	1027 BELLEVUE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-1996
Country	:	US
Telephone Number	:	314-447-9705
Fax Number	:

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

Provider Enumeration Date	:	09/29/2009
Last Update Date	:	02/04/2026

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