Individual
LAURIE LEE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
2601 13TH ST, PORT HURON, MI 48060-6546
(810) 987-9100
Mailing address
3405 CRANBERRY DR, CLYDE, MI 48049-4403
(810) 984-2491
(810) 987-9105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1-01753
MI
104100000X
Social Worker
6802012074
MI
Other
Enumeration date
08/27/2006
Last updated
09/11/2025
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