Provider Demographics
NPI:1154022713
Name:DUECK, LAUREN TAYLOR (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:TAYLOR
Last Name:DUECK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:TAYLOR
Other - Last Name:ROMEO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2043 AVALON PARK SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7799
Mailing Address - Country:US
Mailing Address - Phone:813-409-1951
Mailing Address - Fax:
Practice Address - Street 1:2043 AVALON PARK SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7799
Practice Address - Country:US
Practice Address - Phone:813-409-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health