Active NPI
Lauren Mangus
- Clinical Psychologist
- Southfield, MI
National Provider Identifier
1669725347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301017943
- Practice address
- 30503 Greenfield Rd
Southfield, MI 48076-1594 - Phone
- (248) 691-4744
- NPI assigned
- Oct 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301017943 | MI | Primary |
| Psychologist | 103T00000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | 6301017943 | MI |
Addresses
Primary practice location
30503 Greenfield Rd
Southfield, MI 48076-1594
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lmangus547687@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301017943 | MI | MD | Clinical Child & Adolescent Psychologist |
Interoperability endpoints
- lmangus547687@direct.beaumont.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776297600000",
"number": "1669725347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30503 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480761594",
"telephone_number": "248-691-4744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUS",
"first_name": "LAUREN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-18",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301017943",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MI",
"license": "6301017943",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lmangus547687@direct.beaumont.edu",
"affiliation": "N",
"address_1": "30503 Greenfield Rd",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480761594",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.