Provider Demographics
NPI:1942842448
Name:HALLACELI, LAUREN (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HALLACELI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3131 E KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:MIKADO
Mailing Address - State:MI
Mailing Address - Zip Code:48745-9610
Mailing Address - Country:US
Mailing Address - Phone:989-335-1851
Mailing Address - Fax:
Practice Address - Street 1:1360 MONTAUK HWY STE 1
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-2929
Practice Address - Country:US
Practice Address - Phone:631-721-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009012101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor