MEDICARE: LAUREN SMITH 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	1041C0700X	Clinical Social Worker	6801119714	MI

General Provider Information

NPI Number	:	1932913639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN SMITH LMSW

Provider Business Mailing Address
First Line	:	6098 S STATE RD
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-9702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6098 S STATE RD
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-9702
Country	:	US
Telephone Number	:	989-884-1079
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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