MEDICARE: LAUREN MARIE STADELBAUER LMHC

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	101YM0800X	Mental Health Counselor	MHC01833	RI

General Provider Information

NPI Number	:	1346723541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MARIE STADELBAUER LMHC

Provider Business Mailing Address
First Line	:	49 DELTA ST
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-6603
Country	:	US
Telephone Number	:	401-952-2702
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 FLEMING RD
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02920-3057
Country	:	US
Telephone Number	:	401-462-1000
Fax Number	:

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

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	05/05/2026

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