Provider Demographics
NPI:1154497469
Name:LEVINE, LAUREN ELLEN (LPC-S)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELLEN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELLEN
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5210 W VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8104
Mailing Address - Country:US
Mailing Address - Phone:479-236-4172
Mailing Address - Fax:
Practice Address - Street 1:5210 W VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8104
Practice Address - Country:US
Practice Address - Phone:479-236-4172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0204020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional