Individual provider Active NPI

Lauren Dorris, LCSW

  • Clinical Social Worker
  • Bowling Green, KY
National Provider Identifier
1538801592
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
258228 Issued in KY
Practice address
1312 Westen St
Bowling Green, KY 42104-3352
Phone
(270) 904-1072
Fax
(270) 904-1073
NPI assigned
Apr 11, 2022
Last updated
Jul 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 258228 KY Primary

Addresses

Primary practice location

1312 Westen St
Bowling Green, KY 42104-3352

Mailing address

1312 Westen St
Bowling Green, KY 42104-3352
Phone (270) 904-1072

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.wilsoncounselingllc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
258228KYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1538801592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 WESTEN ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043352",
            "telephone_number": "270-904-1072",
            "fax_number": "270-904-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 WESTEN ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043352",
            "telephone_number": "270-904-1072",
            "fax_number": "270-904-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORRIS",
        "first_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "258228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.wilsoncounselingllc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "URL",
            "address_1": "1312 Westen St",
            "city": "Bowling Green",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421043352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.