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General NPI Number Information
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NPI Number | 1619694403
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Entity Type | Individual
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Provider Name | LAUREA MARSHALL MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 31815 SOUTHFIELD RD STE 18
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5471
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Country | US
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Telephone | 248-480-0115
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Fax |
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Provider Business Mailing Address
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Address Line | 23077 GREENFIELD RD STE 455
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3740
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Country | US
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Telephone | 248-794-6292
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401223856
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401223856
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License Number State | MI
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