Provider Demographics
NPI:1871366591
Name:MILLER, LAUREN C (MED, LSWA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:MILLER
Suffix:
Gender:F
Credentials:MED, LSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 STOCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1295
Mailing Address - Country:US
Mailing Address - Phone:413-528-8580
Mailing Address - Fax:
Practice Address - Street 1:444 STOCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1295
Practice Address - Country:US
Practice Address - Phone:413-528-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALSWA415200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker