Healthcare Provider Details

I. General information

NPI: 1992609127
Provider Name (Legal Business Name): MRS. LAUREN ANN SCANLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OXBOW LAKE RD
WHITE LAKE MI
48386-2621
US

IV. Provider business mailing address

4851 STUHRBERG DR
BRIGHTON MI
48114-8618
US

V. Phone/Fax

Practice location:
  • Phone: 248-684-8011
  • Fax:
Mailing address:
  • Phone: 248-342-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117359
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: