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Individual
LAURIE J CHURCH
Active
Individual
LAURIE J CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LPC NCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
6401010685
MI
1041C0700X
Clinical Social Worker
Primary
6401010685
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215426747
TYPE II NPI
—
05
—
1508034661
—
MI
01
—
15080346641
TYPE I NPI
—
Enumeration date
02/12/2008
Last updated
05/31/2018
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