Provider Demographics
NPI:1831079649
Name:MACEK, LAUREN VINCENZA (PSYCHOLOGY ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:VINCENZA
Last Name:MACEK
Suffix:
Gender:F
Credentials:PSYCHOLOGY ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 CRESTNOLL RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5645
Mailing Address - Country:US
Mailing Address - Phone:443-805-5212
Mailing Address - Fax:
Practice Address - Street 1:3 TALBOTT AVE STE 100
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2329
Practice Address - Country:US
Practice Address - Phone:443-805-5212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01175390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program