Healthcare Provider Details

I. General information

NPI: 1235500331
Provider Name (Legal Business Name): LAUREN RAE RUBEN MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 WATER TOWER PL STE 340
CLARKSTON MI
48346-2671
US

IV. Provider business mailing address

5701 BOW POINTE DR STE 100
CLARKSTON MI
48346-3199
US

V. Phone/Fax

Practice location:
  • Phone: 483-848-1302
  • Fax: 248-384-8131
Mailing address:
  • Phone: 248-625-2621
  • Fax: 248-625-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401015050
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015050
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: