Healthcare Provider Details

I. General information

NPI: 1548917719
Provider Name (Legal Business Name): LAUREN ANDERSON SPRAGUE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MONROE AVE NW
GRAND RAPIDS MI
49503-1455
US

IV. Provider business mailing address

1530 GROTON RD SE
GRAND RAPIDS MI
49506-4754
US

V. Phone/Fax

Practice location:
  • Phone: 616-259-7207
  • Fax:
Mailing address:
  • Phone: 847-873-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801114517
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: