Lauren Lietaert LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LAUREN LIETAERT LLC

Practice address

16645 15 Mile Rd
Clinton Township, MI 48035-2206

Phone

(586) 213-5505

Fax

(586) 213-5504

NPI assigned

Jan 18, 2024

Last updated

Jan 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren Lietaert, NPNPI 1508275330

Title

Owner/Managing Member/Pmhnp

Phone

(586) 533-5672

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Lietaert, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton Township, MI
  • NPI 1508275330
  NPD Authorized official

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1528829447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16645 15 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352206",
            "telephone_number": "586-213-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 15 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352206",
            "telephone_number": "586-213-5505",
            "fax_number": "586-213-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREN LIETAERT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-13",
        "status": "A",
        "authorized_official_last_name": "LIETAERT",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER/PMHNP",
        "authorized_official_telephone_number": "586-533-5672",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.