Boucek, Lauren D

Boucek, Lauren D is an individual health care provider with primary practice located at 1813 W. Kirby Ave , Champaign IL 61821-5410. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Boucek, Lauren D can be contacted via phone (217) 383-1850.

Contact Information

Primary practice address
1813 W. Kirby Ave Champaign IL 61821-5410
Phone: (217) 383-1850
Fax: (217) 383-3439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 23179 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149016829 Illinois

Profile Details

NPI number 1487719191
LBN Legal business name Boucek, Lauren D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2006
Last updated Nov 7th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487719191 NPPES
California Other LCSW23179 LICENSE CLINICAL SOCIAL W

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