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General NPI Number Information
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NPI Number | 1174034813
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Entity Type | Individual
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Provider Name | RACHAEL SUE LAURIN LLMSW
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 104 MALTON RD
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City | NEGAUNEE
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State | MI
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Zip | 49866-2000
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Country | US
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Telephone | 906-228-4692
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Fax | 906-228-2830
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Provider Business Mailing Address
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Address Line | 5087 US HIGHWAY 41 S
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City | MARQUETTE
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State | MI
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Zip | 49855-9001
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Country | US
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Telephone | 906-869-3581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6851115194
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MI
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