Provider Demographics
NPI:1235500331
Name:RUBEN, LAUREN RAE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RAE
Last Name:RUBEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7640 DIXIE HWY STE 155
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2095
Mailing Address - Country:US
Mailing Address - Phone:248-791-9266
Mailing Address - Fax:248-392-2601
Practice Address - Street 1:7640 DIXIE HWY STE 155
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2095
Practice Address - Country:US
Practice Address - Phone:248-791-9266
Practice Address - Fax:248-392-2601
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015050101YP2500X, 101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional