Healthcare Provider Details

I. General information

NPI: 1679562854
Provider Name (Legal Business Name): JANINE B LARIVIERE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N MAIN ST SUITE C - 17
BELLINGHAM MA
02019-1548
US

IV. Provider business mailing address

153 MONROE ST
DOUGLAS MA
01516-2307
US

V. Phone/Fax

Practice location:
  • Phone: 508-966-4002
  • Fax: 508-966-2072
Mailing address:
  • Phone: 508-476-7986
  • Fax: 508-966-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3951
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierLM0776
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerBLUE CROSS, MA
# 2
IdentifierNZ791
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerEMPIRE BLUE CROSS
# 3
Identifier62-52249
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerUBH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: