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NPI Code Detail

MEDICARE: LAUREN VANDERVOORT

MEDICARE: LAUREN VANDERVOORT
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
1101Y00000XCounselorH09604436160934NJ

General Provider Information

NPI Number : 1982059325
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN VANDERVOORT
Provider Business Mailing Address
First Line : 3 BLACKBURN CTR
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-2268
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3 BLACKBURN CTR
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-2268
Country : US
Telephone Number : 978-793-6022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2016
Last Update Date : 06/17/2024

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Directions to “ LAUREN VANDERVOORT ” Practice Location

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