Provider Demographics
NPI:1053514174
Name:TREVATHAN, LAUREN OLIVIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:OLIVIA
Last Name:TREVATHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 LIPSCOMB DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7007
Mailing Address - Country:US
Mailing Address - Phone:615-370-2441
Mailing Address - Fax:
Practice Address - Street 1:2200 21ST AVE S
Practice Address - Street 2:SUITE 229
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4942
Practice Address - Country:US
Practice Address - Phone:615-828-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4351101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health