Provider Demographics
NPI:1871329623
Name:STRAILEY, LAUREN (MS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:STRAILEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S 19TH ST APT UNITB
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2637
Mailing Address - Country:US
Mailing Address - Phone:484-343-0270
Mailing Address - Fax:
Practice Address - Street 1:3550 DARBY RD
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1018
Practice Address - Country:US
Practice Address - Phone:484-580-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health