Provider Demographics
NPI:1548818461
Name:WIMER, LAUREN LOUISE (LSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:LOUISE
Last Name:WIMER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 RENNELLS AVE
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2349
Mailing Address - Country:US
Mailing Address - Phone:330-979-7250
Mailing Address - Fax:
Practice Address - Street 1:2282 REEVES ROAD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-4354
Practice Address - Country:US
Practice Address - Phone:330-372-2010
Practice Address - Fax:330-372-3446
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1904276104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker