Provider Demographics
NPI:1609359751
Name:SPECTOR, LAUREN (LSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 STATION ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4968
Mailing Address - Country:US
Mailing Address - Phone:216-512-1520
Mailing Address - Fax:
Practice Address - Street 1:8500 STATION ST STE 102
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4968
Practice Address - Country:US
Practice Address - Phone:216-512-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1800579-TRNE104100000X
OHS.2106012104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker