Lauren Alexandra Waller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09929799 Issued in CO

Practice address

1790 30TH St Ste 350
Boulder, CO 80301-1071

Phone

(720) 585-3271

NPI assigned

Jun 23, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Alexa Worthington Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hope Institute of America

  • Mental Health Counselor
  • Perrysburg, OH
  • NPI 1336822824

  Social Worker

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1104231612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 THISTLE PL",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805043907",
            "telephone_number": "303-809-1371",
            "fax_number": "303-420-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 30TH ST STE 350",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011071",
            "telephone_number": "720-585-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "LAUREN",
        "middle_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09929799",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "LSW.0009923130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXA",
            "last_name": "WORTHINGTON",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Wallace, LPC
• Mary Louise Wallace, MA, CCC-SLP
• Tereasa Anne Wallace, RN, MN
• Cathrine Skogheim Walle, D.C., B.S.
• Katherine Eleanor Waller
• Meredith Ann Waller, LCSW
• Ruth Stephanie Waller, P.T.
• Leah Wallerstein, M.A.
• Sean Wallis, NP
• Lucas Bryant Walljasper

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.