Lauren Borduin Quetsch, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

202125 Issued in AR

Practice address

480 N Campus Drive, University of Arkansas
Memorial Hall 111, Psychological Clinic
Fayetteville, AR 72701

Phone

(479) 575-4258

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren E Borduin Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Arkansas Childrens Hospital

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• Arkansas Children'S Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Adolescent Medicine (Family Medicine) Physician
  • Little Rock, AR
  • NPI 1285307744
  NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1942707237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 N CAMPUS DRIVE, MEMORIAL HALL 216",
            "address_2": "UNIVERSITY OF ARKANSAS, DEPARTMENT OF PSYCH",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "573-356-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N CAMPUS DRIVE, UNIVERSITY OF ARKANSAS",
            "address_2": "MEMORIAL HALL 111, PSYCHOLOGICAL CLINIC",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "479-575-4258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 Gene George Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727623180",
            "country_code": "US",
            "telephone_number": "479-750-0125",
            "fax_number": "479-450-0323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUETSCH",
        "first_name": "LAUREN",
        "middle_name": "BORDUIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "202125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BORDUIN",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.