Provider Demographics
NPI:1215291307
Name:VAN HULLE, LAUREN E (MA, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:VAN HULLE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:E
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22170 W 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-6007
Mailing Address - Country:US
Mailing Address - Phone:248-372-6877
Mailing Address - Fax:
Practice Address - Street 1:22170 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-6007
Practice Address - Country:US
Practice Address - Phone:248-372-6877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013074101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor