Healthcare Provider Details

I. General information

NPI: 1710431341
Provider Name (Legal Business Name): LAUREN FREY LMSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 CENTURION DR STE 120
LANSING MI
48917-8273
US

IV. Provider business mailing address

6639 CENTURION DR STE 120
LANSING MI
48917-8273
US

V. Phone/Fax

Practice location:
  • Phone: 517-258-0364
  • Fax: 517-299-1027
Mailing address:
  • Phone: 517-295-3309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801110310
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: