Lauren E. St. Amour, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006819 Issued in CT

Practice address

47 Water St Ste 202
Mystic, CT 06355-2573

Phone

(617) 416-0597

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Lauren E. Faucher Former name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mystic Services, LLC

  • Community/Behavioral Health Agency
  • Mystic, CT
  • NPI 1720619364
  Medicare reassignment NPD Authorized official
• Mystic Bridge to Wellness, LLC

  • Community/Behavioral Health Agency
  • Mystic, CT
  • NPI 1750044509
  NPD Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1659412153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JOYCE ST",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552947",
            "telephone_number": "617-416-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WATER ST STE 202",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552573",
            "telephone_number": "617-416-0597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Whitehall Ave",
            "address_purpose": "LOCATION",
            "city": "Mystic",
            "state": "CT",
            "postal_code": "06355",
            "country_code": "US",
            "telephone_number": "860-961-5702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST. AMOUR",
        "first_name": "LAUREN",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01765",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "007059145",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LF65486",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600052-721",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31443-5",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "413425",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NHP",
            "identifier": "1021740",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "FAUCHER",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Soito, DPT
• Jessica W. Sormrude, MED, LCSW
• Spectrum Physical Therapy Limited Partnership
• Spectrum Physical Therapy Limited Partnership
• SSC Mystic Operating Company LLC
• Owen Stanfield
• Julia C Stapans, DPT
• State of CT.- Office of the Comptroller
• State of CT.- Office of the Comptroller
• Kristen Maria Stehle, A.P.R.N.

• Clinical Social Worker in Mystic, CT
• Providers in Mystic, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.