Provider Demographics
NPI:1679712988
Name:SCOTT, LAUREN SUSANNE (LCSW-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:SUSANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLAGE SQUARE 2
Mailing Address - Street 2:SUITE 259
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:410-466-4917
Mailing Address - Fax:410-323-6705
Practice Address - Street 1:VILLAGE SQUARE 2
Practice Address - Street 2:SUITE 259
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:410-466-4917
Practice Address - Fax:410-323-6705
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical