Healthcare Provider Details

I. General information

NPI: 1689282311
Provider Name (Legal Business Name): LAUREN ELIZABETH NELSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 KERRY ST
LANSING MI
48912-3658
US

IV. Provider business mailing address

5172 MADISON AVE APT B11
OKEMOS MI
48864-5120
US

V. Phone/Fax

Practice location:
  • Phone: 517-273-2706
  • Fax:
Mailing address:
  • Phone: 248-756-2310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117909
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: