MEDICARE: LAUREN KOMP LCSW

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	1041C0700X	Clinical Social Worker	2016012305	MO

General Provider Information

NPI Number	:	1427471176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN KOMP LCSW

Provider Business Mailing Address
First Line	:	1726 NICHOLSON PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2614
Country	:	US
Telephone Number	:	518-332-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1726 NICHOLSON PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2614
Country	:	US
Telephone Number	:	636-946-4000
Fax Number	:

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

Provider Enumeration Date	:	01/31/2014
Last Update Date	:	08/04/2021

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