Healthcare Provider Details

I. General information

NPI: 1194675835
Provider Name (Legal Business Name): LUCY LAFLEUR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 PINECREST AVE SE
GRAND RAPIDS MI
49506-3411
US

IV. Provider business mailing address

1124 PINECREST AVE SE
GRAND RAPIDS MI
49506-3411
US

V. Phone/Fax

Practice location:
  • Phone: 616-241-2652
  • Fax:
Mailing address:
  • Phone: 616-241-2652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801062872
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: