Provider Demographics
NPI:1134007230
Name:LAYCHUR, LAURYN (RCSWI)
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:
Last Name:LAYCHUR
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 NE PECOS WAY
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-6692
Mailing Address - Country:US
Mailing Address - Phone:772-204-3384
Mailing Address - Fax:
Practice Address - Street 1:900 SE OCEAN BLVD STE 340E
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3502
Practice Address - Country:US
Practice Address - Phone:772-220-3439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18432251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health