MEDICARE: LAUREN AMLALO LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6801101883	MI

General Provider Information

NPI Number	:	1396197802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN AMLALO LMSW

Provider Business Mailing Address
First Line	:	2730 5 MILE RD NE STE 101
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-6518
Country	:	US
Telephone Number	:	616-426-9401
Fax Number	:	616-333-4303

Provider Business Practice Location Address
First Line	:	2730 5 MILE RD NE STE 101
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-6518
Country	:	US
Telephone Number	:	616-426-9401
Fax Number	:	616-333-4303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	04/07/2026

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Directions to “ LAUREN AMLALO LMSW” Practice Location

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