Provider Demographics
NPI:1063980399
Name:FARAGO, LAUREN (LGPC, NCC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:FARAGO
Suffix:
Gender:F
Credentials:LGPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16213 HIDDEN PONDS WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2214
Mailing Address - Country:US
Mailing Address - Phone:240-751-0185
Mailing Address - Fax:
Practice Address - Street 1:16213 HIDDEN PONDS WAY
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2214
Practice Address - Country:US
Practice Address - Phone:240-751-0185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9079101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional