Individual ProviderLauren ShapovalovaCounselorBehavioral Health & Social Service ProvidersPractice Address2460 Victory Blvd, Staten Island, NY 10314-6612(917) 781-0041(908) 977-6726PECOS EnrollmentBased on the most recent information from CMS, provider Lauren Shapovalova does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 1:08 PM.Profile DetailsProvider ID1114810009Provider TypeIndividualFull NameShapovalova, LaurenGenderFemaleSole ProprietorNoEnumeration Date5/30/2025Last Updated5/30/2025Contact InformationPractice LocationPractice Address2460 Victory Blvd, Staten Island, NY 10314-6612Phone(917) 781-0041FaxUnlisted FaxMailing LocationMailing Address4077 Hylan Blvd # 10, Staten Island, NY 10308-3334Phone(908) 977-6726FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer