Healthcare Provider Details

I. General information

NPI: 1609539873
Provider Name (Legal Business Name): YVETTE M LAWHORN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BROADWAY
BEVERLY MA
01915-4418
US

IV. Provider business mailing address

20 FOREST ST UNIT 8
MEDFORD MA
02155-7701
US

V. Phone/Fax

Practice location:
  • Phone: 617-468-8570
  • Fax: 978-307-3083
Mailing address:
  • Phone: 617-468-8570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: