MEDICARE: MS. LAUREN ELIZABETH DORNELL-NEAL LCMHC, LCAS, DOULA

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	374J00000X	Doula
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-2834	NC
3	101YM0800X	Mental Health Counselor	9301	NC
4	101YP2500X	Professional Counselor	9301	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326382557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN ELIZABETH DORNELL-NEAL LCMHC, LCAS, DOULA

Provider Business Mailing Address
First Line	:	521 YOPP RD STE 214-308
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	980-355-2260
Fax Number	:	833-837-7903

Provider Business Practice Location Address
First Line	:	521 YOPP RD STE 214-308
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	980-355-2260
Fax Number	:	833-837-7903

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

Provider Enumeration Date	:	11/10/2012
Last Update Date	:	03/24/2025

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