Provider Demographics
NPI:1043267040
Name:LAZAR, JOAN FRANCES (MA, LLP, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:FRANCES
Last Name:LAZAR
Suffix:
Gender:F
Credentials:MA, LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 W MAPLE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4405
Mailing Address - Country:US
Mailing Address - Phone:248-489-1550
Mailing Address - Fax:248-489-9767
Practice Address - Street 1:6024 W MAPLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4405
Practice Address - Country:US
Practice Address - Phone:248-489-1550
Practice Address - Fax:248-489-9767
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008586103TB0200X
MI6361001644103TC0700X
MI6401010065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional