Lauren Elizabeth Blake, LLMFT
Individual provider Active NPI Marriage & Family Therapist · Grass Lake, MI
NPI 1306594189 · NPPES record last updated Nov 12, 2022
Key facts
- NPI
- 1306594189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 4151001039 (MI)
- Practice address
- 4769 Norvell Rd
Grass Lake, MI 49240-9726 - Phone
- (678) 897-9796
- NPI assigned
- Mar 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4151001039 | MI | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4151001039 | MI | Yes |
Addresses
Primary practice location
4769 Norvell Rd
Grass Lake, MI 49240-9726
Mailing address
4769 Norvell Rd
Grass Lake, MI 49240-9726
Phone (678) 897-9796
Other providers in Grass Lake, MI
- All Together Pharmacy
- Andrew Andonian
- Kathleen Anzicek
- Be Active Physical Therapy & Wellness, PLLC
- Rebecca L Bowman
- Nancy Ann Brown
- Luciana Castro
- Cedar Knoll Care Center
- Aaron Cole
All providers in Grass Lake, MI · Marriage & Family Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.