MEDICARE: JOANNA LAUREN RN, LPC

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	101YP2500X	Professional Counselor	89946	TX

General Provider Information

NPI Number	:	1710612460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA LAUREN RN, LPC

Provider Business Mailing Address
First Line	:	10427 EAGLE GLEN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77041-8706
Country	:	US
Telephone Number	:	315-807-9118
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-5255
Country	:	US
Telephone Number	:	713-628-8197
Fax Number	:

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

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	05/22/2025

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