Provider Demographics
NPI:1396259529
Name:THOMAS, LAUREN ASHLEIGH
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ASHLEIGH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10182 N 457 E
Mailing Address - Street 2:
Mailing Address - City:DEMOTTE
Mailing Address - State:IN
Mailing Address - Zip Code:46310-8913
Mailing Address - Country:US
Mailing Address - Phone:810-423-8012
Mailing Address - Fax:
Practice Address - Street 1:2068 LUCAS PKWY
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-2169
Practice Address - Country:US
Practice Address - Phone:219-690-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor