Provider Demographics
NPI:1528819844
Name:GREGARCZYK, LAUREN B (LCDP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:B
Last Name:GREGARCZYK
Suffix:
Gender:F
Credentials:LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 JOHNNY CAKE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5674
Mailing Address - Country:US
Mailing Address - Phone:401-843-1213
Mailing Address - Fax:
Practice Address - Street 1:42 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-6400
Practice Address - Country:US
Practice Address - Phone:401-843-1213
Practice Address - Fax:401-848-6398
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP00901101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health