Provider Demographics
NPI:1043767650
Name:LAFLEUR, LAUREN ALEXIS (LMSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALEXIS
Last Name:LAFLEUR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ALEXIS
Other - Last Name:LAFLEUR-KILYANEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:114 ORCHARD LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-2244
Mailing Address - Country:US
Mailing Address - Phone:248-858-7766
Mailing Address - Fax:248-858-7258
Practice Address - Street 1:114 ORCHARD LAKE ROAD
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2244
Practice Address - Country:US
Practice Address - Phone:248-858-7766
Practice Address - Fax:248-858-7258
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010897771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical