Provider Demographics
NPI:1851796767
Name:LUNA, LAUREN A (LMSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:LUNA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MARTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:35455 GARFIELD RD STE C
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-2236
Mailing Address - Country:US
Mailing Address - Phone:586-792-5335
Mailing Address - Fax:
Practice Address - Street 1:35455 GARFIELD RD STE C
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-2236
Practice Address - Country:US
Practice Address - Phone:586-792-5335
Practice Address - Fax:586-792-3061
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801097584171M00000X
MI68011049001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator