Healthcare Provider Details

I. General information

NPI: 1649960352
Provider Name (Legal Business Name): LAUREL KUIPERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COURTHOUSE LN STE 3
CHELMSFORD MA
01824-1723
US

IV. Provider business mailing address

2 COURTHOUSE LN STE 3
CHELMSFORD MA
01824-1723
US

V. Phone/Fax

Practice location:
  • Phone: 978-275-9444
  • Fax: 978-275-9918
Mailing address:
  • Phone: 978-275-9444
  • Fax: 978-275-9918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW202717
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: