Provider Demographics
NPI:1386352201
Name:WELCH, LAUREN ALICIA ELAINE (BA)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ALICIA ELAINE
Last Name:WELCH
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 BIROTH CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0180
Mailing Address - Country:US
Mailing Address - Phone:702-524-8233
Mailing Address - Fax:
Practice Address - Street 1:70 SOUTH HWY 160
Practice Address - Street 2:SUITE 104
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:702-406-7133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty