Provider Demographics
NPI:1316272750
Name:RICHARDS, LAUREN GARRISON (BA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GARRISON
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1382 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2351
Mailing Address - Country:US
Mailing Address - Phone:502-637-4361
Mailing Address - Fax:
Practice Address - Street 1:1382 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-2351
Practice Address - Country:US
Practice Address - Phone:502-637-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker