Provider Demographics
NPI:1124673827
Name:JARREAU, LAUREN RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RENEE
Last Name:JARREAU
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 1:313 W WOLF POINT PLZ UNIT 503
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8902
Mailing Address - Country:US
Mailing Address - Phone:225-718-2328
Mailing Address - Fax:
Practice Address - Street 1:313 W WOLF POINT PLZ UNIT 503
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-8902
Practice Address - Country:US
Practice Address - Phone:225-718-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490239921041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker