Provider Demographics
NPI:1871703074
Name:SPIVEY, LAUREN JANNELL (MMFT, MA ED)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JANNELL
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:MMFT, MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 HARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-3919
Mailing Address - Country:US
Mailing Address - Phone:972-977-5485
Mailing Address - Fax:
Practice Address - Street 1:12740 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2038
Practice Address - Country:US
Practice Address - Phone:972-233-0721
Practice Address - Fax:972-233-0751
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor