Provider Demographics
NPI:1386111359
Name:RENAUD, LAURA FRANCES (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FRANCES
Last Name:RENAUD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28436 N CLEMENTS CIR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3102
Mailing Address - Country:US
Mailing Address - Phone:313-586-2456
Mailing Address - Fax:
Practice Address - Street 1:2500 PACKARD ST STE 101A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6827
Practice Address - Country:US
Practice Address - Phone:734-277-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010991941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical