MEDICARE: DR. LAWRENCE MICHAEL CAMERON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	9687	CT
2	101Y00000X	Counselor	6401002606	MI
3	101YP2500X	Professional Counselor	6401002606	MI

General Provider Information

NPI Number	:	1417245770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE MICHAEL CAMERON LPC

Provider Business Mailing Address
First Line	:	3210 GLENDALE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3333
Country	:	US
Telephone Number	:	734-652-1471
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 GLENDALE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48238-3333
Country	:	US
Telephone Number	:	734-652-1471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	05/15/2026

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