Provider Demographics
NPI:1700141959
Name:SWAIN, LAUREN SHREVE (MA, LCAS, LPCA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:SHREVE
Last Name:SWAIN
Suffix:
Gender:F
Credentials:MA, LCAS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600-F LYNNDALE CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4196
Mailing Address - Country:US
Mailing Address - Phone:252-353-8001
Mailing Address - Fax:
Practice Address - Street 1:600 LYNNDALE CT SUITE F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4196
Practice Address - Country:US
Practice Address - Phone:252-353-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-2853101YA0400X
NCA9691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301656Medicaid