Provider Demographics
NPI:1376015370
Name:CONIBEAR, LAUREN (LPC, PMH-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CONIBEAR
Suffix:
Gender:F
Credentials:LPC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57559 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-3571
Mailing Address - Country:US
Mailing Address - Phone:586-588-1965
Mailing Address - Fax:
Practice Address - Street 1:57559 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-3571
Practice Address - Country:US
Practice Address - Phone:586-588-1965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016429101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor