Provider Demographics
NPI:1295443240
Name:EDWARDS, LAUREN (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MONROE PKWY STE P
Mailing Address - Street 2:PMB 120
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8899
Mailing Address - Country:US
Mailing Address - Phone:503-481-1269
Mailing Address - Fax:503-500-5587
Practice Address - Street 1:4900 MEADOWS RD STE 400
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3298
Practice Address - Country:US
Practice Address - Phone:503-481-1269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL111631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical