Individual provider Active NPI

M. Lauren Earls, PH.D.

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1154638666
Registry record updated Jun 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2062561 Issued in MI
Practice address
514 E William St Ste a
Ann Arbor, MI 48104-2446
Phone
(734) 707-3993
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2062561 MI Primary

Addresses

Primary practice location

514 E William St Ste a
Ann Arbor, MI 48104-2446

Mailing address

514 E William St Ste a
Ann Arbor, MI 48104-2446
Phone (734) 707-3993

Other identifiers 1

IdentifierTypeStateIssuer
1154638666OtherMINATIONAL PROVIDER IDENTIFIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2062561MIMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339200000000",
    "number": "1154638666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 E WILLIAM ST STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042446",
            "telephone_number": "734-707-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 E WILLIAM ST STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042446",
            "telephone_number": "734-707-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLS",
        "first_name": "M. LAUREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2012-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "2062561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1154638666",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.