Provider Demographics
NPI:1063173276
Name:GIUMARRA, LAUREN (LICSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GIUMARRA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-0101
Mailing Address - Country:US
Mailing Address - Phone:802-391-9514
Mailing Address - Fax:
Practice Address - Street 1:337 COLLEGE ST STE 302
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8344
Practice Address - Country:US
Practice Address - Phone:802-391-9514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01344831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical