Provider Demographics
NPI:1548475007
Name:DOTTOR, LAUREN ELIZABETH (DSW, MSW, MS)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:DOTTOR
Suffix:
Gender:F
Credentials:DSW, MSW, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:FOUNTAINVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18923-0159
Mailing Address - Country:US
Mailing Address - Phone:267-421-7921
Mailing Address - Fax:
Practice Address - Street 1:5055 SWAMP RD STE 202
Practice Address - Street 2:
Practice Address - City:FOUNTAINVILLE
Practice Address - State:PA
Practice Address - Zip Code:18923-9655
Practice Address - Country:US
Practice Address - Phone:267-421-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004497101YP2500X
PACW0164621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional