Provider Demographics
NPI:1740853266
Name:CUNNANE, LAUREN (MSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CUNNANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2397
Mailing Address - Country:US
Mailing Address - Phone:773-715-9934
Mailing Address - Fax:
Practice Address - Street 1:555 E WILLIAM ST APT 25G
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2428
Practice Address - Country:US
Practice Address - Phone:734-234-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511102091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical