Provider Demographics
NPI:1316049349
Name:ALLOY, LAUREN D (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:D
Last Name:ALLOY
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 1:1924 CLAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3438
Mailing Address - Country:US
Mailing Address - Phone:678-637-7797
Mailing Address - Fax:
Practice Address - Street 1:1924 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3438
Practice Address - Country:US
Practice Address - Phone:678-637-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0018921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA274525864AMedicaid
Q23291Medicare UPIN
80BBFTXMedicare ID - Type Unspecified