Provider Demographics
NPI:1467034272
Name:MAGUIRE, LAUREN (MA, SCL, LLPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:MA, SCL, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1022
Mailing Address - Country:US
Mailing Address - Phone:231-499-8907
Mailing Address - Fax:
Practice Address - Street 1:1553 LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1022
Practice Address - Country:US
Practice Address - Phone:231-499-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health