Lauren Renee Favreau, DAC, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC576 Issued in ME

Practice address

60 Pineland Dr Ste 203
New Gloucester, ME 04260-5121

Phone

(207) 808-9174

NPI assigned

Jun 21, 2017

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lauren Renee Dyer Former name

Electronic endpoints 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Empower Chiropractic and Acupuncture

  • Chiropractor
  • New Gloucester, ME
  • NPI 1285185801
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1326568338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WINDHAM CENTER RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040624339",
            "telephone_number": "914-494-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PINELAND DR STE 203",
            "city": "NEW GLOUCESTER",
            "state": "ME",
            "postal_code": "042605121",
            "telephone_number": "207-808-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVREAU",
        "first_name": "LAUREN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DAC,  LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-08-10",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ME",
            "license": "AC576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCAOM (NATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE & ORIENTAL MEDICINE)",
            "identifier": "167026",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://runeacupuncture.com",
            "affiliation": "N",
            "endpointDescription": "Provider Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Web",
            "address_1": "60 Pineland Dr Ste 203",
            "city": "New Gloucester",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042605121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "DYER",
            "middle_name": "RENEE",
            "credential": "DAC, LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan E Delaney, LM, CPM
• Travis Dyer, DC
• Echo Center
• Empower Chiropractic and Acupuncture
• Lydia Farmer, OTR/L
• Richard E Fortier Jr.
• Adam Boyd Gilman, LCPC-C
• Gregory Lee Goding, DMD
• Catherine Skilling Grannell, S/L THERAPIST
• Christina A Grisanzio, CF-SLP

• Acupuncturist in New Gloucester, ME
• Providers in New Gloucester, ME by specialty
• Acupuncturist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.