MEDICARE: LAUREN REAM CADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	02144-I	NV

General Provider Information

NPI Number	:	1386163509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN REAM CADC

Provider Business Mailing Address
First Line	:	7433 FORESTDALE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3852 PALOS VERDES ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6909
Country	:	US
Telephone Number	:	702-485-1210
Fax Number	:

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

Provider Enumeration Date	:	09/19/2017
Last Update Date	:	02/17/2021

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