MEDICARE: LAUREN FREY LMSW-C

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	1041C0700X	Clinical Social Worker	6801110310	MI
2	247200000X	Other Technician

General Provider Information

NPI Number	:	1710431341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN FREY LMSW-C

Provider Business Mailing Address
First Line	:	6639 CENTURION DR STE 120
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-8273
Country	:	US
Telephone Number	:	517-295-3309
Fax Number	:

Provider Business Practice Location Address
First Line	:	6639 CENTURION DR STE 120
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-8273
Country	:	US
Telephone Number	:	517-258-0364
Fax Number	:	517-299-1027

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

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	04/06/2026

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