Healthcare Provider Details

I. General information

NPI: 1740953983
Provider Name (Legal Business Name): LAUREN PRESUTTI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2021
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 RIVER OAKS DR
MILFORD MI
48381-1037
US

IV. Provider business mailing address

343 RIVER OAKS DR
MILFORD MI
48381-1037
US

V. Phone/Fax

Practice location:
  • Phone: 248-717-1232
  • Fax:
Mailing address:
  • Phone: 248-717-1232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA PRESUTTI
Title or Position: MANAGER
Credential:
Phone: 248-685-7687