Provider Demographics
NPI:1578978615
Name:DYE, LAUREN BREEDLOVE (MS, LCMHC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BREEDLOVE
Last Name:DYE
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:BREEDLOVE
Other - Last Name:CLOSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:13604 MERTON WOODS LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-9007
Mailing Address - Country:US
Mailing Address - Phone:704-451-6673
Mailing Address - Fax:
Practice Address - Street 1:13604 MERTON WOODS LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-9007
Practice Address - Country:US
Practice Address - Phone:704-451-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10966101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health