Provider Demographics
NPI:1578710133
Name:HARRISON, LAUREN IVY (MA, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:IVY
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:IVY
Other - Last Name:KARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:2399 E WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-1955
Mailing Address - Country:US
Mailing Address - Phone:248-475-6300
Mailing Address - Fax:248-475-6370
Practice Address - Street 1:2399 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1955
Practice Address - Country:US
Practice Address - Phone:248-475-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional