Healthcare Provider Details

I. General information

NPI: 1306753207
Provider Name (Legal Business Name): LAUREN KNEELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 CONCORD AVE
CAMBRIDGE MA
02138-1048
US

IV. Provider business mailing address

799 CONCORD AVE
CAMBRIDGE MA
02138-1048
US

V. Phone/Fax

Practice location:
  • Phone: 617-903-7249
  • Fax:
Mailing address:
  • Phone: 617-674-5363
  • Fax: 617-674-5340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW2120251
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: