Provider Demographics
NPI:1366248627
Name:CARPENTER, LAUREN HEALY (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:HEALY
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 LANTERN WALK DR UNIT 2204
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-8775
Mailing Address - Country:US
Mailing Address - Phone:704-352-7624
Mailing Address - Fax:
Practice Address - Street 1:3750 SEA MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7860
Practice Address - Country:US
Practice Address - Phone:843-399-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer