Provider Demographics
NPI:1447812037
Name:CHRISTENSEN, LAUREN WASILCHAK (LICSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:WASILCHAK
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:LUCILLE
Other - Last Name:WASILCHAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:500 INDIANA AVE NW # C-255
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2131
Mailing Address - Country:US
Mailing Address - Phone:202-879-1732
Mailing Address - Fax:
Practice Address - Street 1:500 INDIANA AVE NW # C-255
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2131
Practice Address - Country:US
Practice Address - Phone:202-879-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500809051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical