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General NPI Number Information
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NPI Number | 1124954722
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Entity Type | Organization
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Legal Business Name | NURTURE FAMILY CENTER PC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 110 TREALOUT DR STE 201
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City | FENTON
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State | MI
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Zip | 48430-3211
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Country | US
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Telephone | 810-931-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 110 TREALOUT DR STE 201
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City | FENTON
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State | MI
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Zip | 48430-3211
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Country | US
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Telephone | 810-931-1168
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LAUREN PEABODY
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Credential | LMSW
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Telephone | 810-931-1168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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