Healthcare Provider Details

I. General information

NPI: 1124954722
Provider Name (Legal Business Name): NURTURE FAMILY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 TREALOUT DR STE 201
FENTON MI
48430-3211
US

IV. Provider business mailing address

110 TREALOUT DR STE 201
FENTON MI
48430-3211
US

V. Phone/Fax

Practice location:
  • Phone: 810-931-1168
  • Fax:
Mailing address:
  • Phone: 810-931-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LAUREN PEABODY
Title or Position: OWNER/THERAPIST
Credential: LMSW
Phone: 810-931-1168