Provider Demographics
NPI:1003157520
Name:LAY, LAUREN ANN (MA, TLLP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ANN
Last Name:LAY
Suffix:
Gender:F
Credentials:MA, TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 E COURT ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-4054
Mailing Address - Country:US
Mailing Address - Phone:810-232-6081
Mailing Address - Fax:810-232-6510
Practice Address - Street 1:202 W SHIAWASSEE AVE STE 213
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2093
Practice Address - Country:US
Practice Address - Phone:248-245-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MI6301018006103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator