Individual provider Active NPI

Lauren Herline, PSYD

  • Clinical Psychologist
  • Midland, MI
National Provider Identifier
1982057717
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301019551 Issued in MI
Practice address
104 W Wackerly St
Midland, MI 48640-2791
Phone
(989) 486-3021
NPI assigned
Jul 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301017142 MI
Clinical Psychologist 103TC0700X 6351004645 MI
Other Technician 247200000X
Clinical Psychologist 103TC0700X 6301019551 MI Primary

Addresses

Primary practice location

104 W Wackerly St
Midland, MI 48640-2791

Mailing address

104 W Wackerly St
Midland, MI 48640-2791
Phone (989) 486-3021

Other names 1

  • Lauren Stuart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231113000454 MI Practitioner - Clinical Psychologist 3678808870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

104 W Wackerly St
Midland, MI 48640-2791
Phone (989) 486-3021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301017142MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan CurrentSince Nov 24, 2019 Accepting new patients

Locations

655 E Cedar Ave
Gladwin, MI 48624
Phone (989) 426-9295

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1982057717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402791",
            "telephone_number": "989-486-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402791",
            "telephone_number": "989-486-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERLINE",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-17",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017142",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6351004645",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "STUART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.