Provider Demographics
NPI:1457959751
Name:GRANT, LAUREN MAY (LICSW)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:MAY
Last Name:GRANT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 IRA B RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05682
Mailing Address - Country:US
Mailing Address - Phone:502-448-2667
Mailing Address - Fax:
Practice Address - Street 1:23 IRA B RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:VT
Practice Address - Zip Code:05682
Practice Address - Country:US
Practice Address - Phone:502-448-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01362501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical