Provider Demographics
NPI:1184260143
Name:SEXTON, LAUREN MARIE (LLMSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:SEXTON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 CHRYSLER SERVICE DR.
Mailing Address - Street 2:STE. 3B
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-577-1396
Mailing Address - Fax:313-577-1419
Practice Address - Street 1:3901 CHRYSLER SERVICE DRIVE
Practice Address - Street 2:STE. 3B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2167
Practice Address - Country:US
Practice Address - Phone:313-577-1396
Practice Address - Fax:313-577-1419
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011028121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty