MEDICARE: LAUREN CLAIRE STUPP

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	170300000X	Genetic Counselor (M.S.)		GA

General Provider Information

NPI Number	:	1568396034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN CLAIRE STUPP

Provider Business Mailing Address
First Line	:	1006 SAINT CLAIR DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-2647
Country	:	US
Telephone Number	:	404-550-6412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE BLDG C
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-1900
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ LAUREN CLAIRE STUPP ” Practice Location

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