Basic Information
Provider Information
NPI: 1003297490
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOFRANO
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 227 E MAIN ST
Address2:  
City: FESTUS
State: MO
PostalCode: 630281952
CountryCode: US
TelephoneNumber: 6369312700
FaxNumber: 6369315304
Practice Location
Address1: 21 MUNICIPAL DR
Address2:  
City: ARNOLD
State: MO
PostalCode: 630101012
CountryCode: US
TelephoneNumber: 6362966206
FaxNumber: 6362960102
Other Information
ProviderEnumerationDate: 06/11/2015
LastUpdateDate: 09/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X2016029903MOY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YA0400X178.009868ILN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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