Provider Demographics
NPI:1144671918
Name:LAWRENCE, MICHELLE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2948 ARTESIAN RD
Mailing Address - Street 2:112
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8558
Mailing Address - Country:US
Mailing Address - Phone:630-428-7890
Mailing Address - Fax:630-428-7891
Practice Address - Street 1:2948 ARTESIAN RD
Practice Address - Street 2:112
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8558
Practice Address - Country:US
Practice Address - Phone:630-428-7890
Practice Address - Fax:630-428-7891
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional