Healthcare Provider Details

I. General information

NPI: 1619723236
Provider Name (Legal Business Name): LAUREN BASINGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W LINCOLN AVE
CHEBOYGAN MI
49721-1858
US

IV. Provider business mailing address

PO BOX 427
HILLMAN MI
49746-0427
US

V. Phone/Fax

Practice location:
  • Phone: 231-597-9585
  • Fax: 989-318-4606
Mailing address:
  • Phone: 989-354-2197
  • Fax: 989-354-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: