1033327457 NPI number — MRS. LAUREN MICHELLE GREENBERG LCSW

Table of content: MRS. LAUREN MICHELLE GREENBERG LCSW (NPI 1033327457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033327457 NPI number — MRS. LAUREN MICHELLE GREENBERG LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREENBERG
Provider First Name:
LAUREN
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GASPAR
Provider Other First Name:
LAUREN
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1033327457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4131 SPICEWOOD SPRINGS RD
Provider Second Line Business Mailing Address:
SUITE F1
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759-8661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-296-7258
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4131 SPICEWOOD SPRINGS RD
Provider Second Line Business Practice Location Address:
SUITE F1
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78759-8661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-296-7258
Provider Business Practice Location Address Fax Number:
512-997-9736
Provider Enumeration Date:
05/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  41024 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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