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NPI Code Detail

MEDICARE: LAUREN E GUSMAN LPCC

MEDICARE: LAUREN E GUSMAN LPCC
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
1101YM0800XMental Health CounselorC1300668OH
2101YP2500XProfessional CounselorE1800616OH

General Provider Information

NPI Number : 1376921015
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN E GUSMAN LPCC
Provider Business Mailing Address
First Line : 601 S EDWIN C MOSES BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45417-3424
Country : US
Telephone Number : 937-734-8333
Fax Number : 937-734-8252
Provider Business Practice Location Address
First Line : 11156 CANAL RD STE A
Second Line :
City : CINCINNATI
State : OH
Zip : 45241-5816
Country : US
Telephone Number : 513-772-6166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2015
Last Update Date : 11/04/2024

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