| Lauren Gardiner Therapy Llc | |
|
19295 Eureka Rd Southgate MI 48195-2929 | |
| (734) 365-6683 | |
| Not Available |
| Full Name | Lauren Gardiner Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19295 Eureka Rd, Southgate, Michigan |
| Authorized Official Name and Position | Lauren Gardiner (OWNER) |
| Authorized Official Contact | 7343656683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauren Gardiner Therapy Llc 2201 Deborah Ct Trenton MI 48183-2202 Ph: (734) 365-6683 | Lauren Gardiner Therapy Llc 19295 Eureka Rd Southgate MI 48195-2929 Ph: (734) 365-6683 |
| NPI Number | 1053058180 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 0547649642 |
|---|---|
| Medicare Enrollment ID | O20220621000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053058180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lauren M Gardiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235483264 PECOS PAC ID: 3678852910 Enrollment ID: I20161109001881 |
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