Basic Information
| Provider Information | |||||||||
| NPI: | 1083687602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATTLE | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | WHEATLEY | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW QCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2817 REILLY ROAD | ||||||||
| Address2: | MCXC-COD CREDENTIALS WOMACK ARMY MEDICAL CENTER | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109078922 | ||||||||
| FaxNumber: | 9109076069 | ||||||||
| Practice Location | |||||||||
| Address1: | 2817 REILLY ROAD | ||||||||
| Address2: | WOMACK ARMY MEDICAL CENTER | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109079822 | ||||||||
| FaxNumber: | 9109076069 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S31690 | TX | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1414997 | 05 | TX | MEDICAID |