MEDICARE: LAUREN KLOOS, LLC

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	116556	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912451576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREN KLOOS, LLC

Provider Business Mailing Address
First Line	:	382 POND ST
Second Line	:
City	:	FRANKLIN
State	:	MA
Zip	:	02038-2892
Country	:	US
Telephone Number	:	508-203-1695
Fax Number	:	508-459-8709

Provider Business Practice Location Address
First Line	:	31 HAYWARD ST
Second Line	:	SUITE 2A
City	:	FRANKLIN
State	:	MA
Zip	:	02038-2166
Country	:	US
Telephone Number	:	508-203-1692
Fax Number	:	508-459-8709

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN KLOOS
Credential	:	LICSW
Telephone Number	:	508-203-1692

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	08/11/2016

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Directions to “LAUREN KLOOS, LLC ” Practice Location

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