Provider Demographics
NPI:1134759434
Name:ONUFRAK, LAUREN MICHELE
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:MICHELE
Last Name:ONUFRAK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:MICHELE
Other - Last Name:CIERVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-9578
Mailing Address - Country:US
Mailing Address - Phone:407-399-8855
Mailing Address - Fax:321-248-0120
Practice Address - Street 1:600 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-9578
Practice Address - Country:US
Practice Address - Phone:407-399-8855
Practice Address - Fax:321-248-0120
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-25
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health