Provider Demographics
NPI:1619632122
Name:LAUREN STOVER
Entity Type:Organization
Organization Name:LAUREN STOVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-701-0837
Mailing Address - Street 1:23710 MARLOW ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1958
Mailing Address - Country:US
Mailing Address - Phone:313-215-0608
Mailing Address - Fax:
Practice Address - Street 1:23710 MARLOW ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1958
Practice Address - Country:US
Practice Address - Phone:313-701-0837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty