Provider Demographics
NPI:1548626195
Name:DRAKE, LAUREN KATERINE (MA, LMHCA)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:KATERINE
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 ENSLEY LN SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4030
Mailing Address - Country:US
Mailing Address - Phone:360-259-4468
Mailing Address - Fax:
Practice Address - Street 1:530 ENSLEY LN SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-4030
Practice Address - Country:US
Practice Address - Phone:360-259-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60508177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health