Provider Demographics
NPI:1982276713
Name:KARL, LAUREN HUNTER
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:HUNTER
Last Name:KARL
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 1:14170 MADDOX RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-6525
Mailing Address - Country:US
Mailing Address - Phone:334-833-2068
Mailing Address - Fax:
Practice Address - Street 1:14170 MADDOX RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-6525
Practice Address - Country:US
Practice Address - Phone:334-833-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL83-1520756Medicaid