Healthcare Provider Details

I. General information

NPI: 1508105339
Provider Name (Legal Business Name): LAUREN LECOMTE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 MAIN ST STE 6-G
MEDWAY MA
02053-1533
US

IV. Provider business mailing address

163 MAIN ST STE 6-G
MEDWAY MA
02053-1533
US

V. Phone/Fax

Practice location:
  • Phone: 618-305-5668
  • Fax:
Mailing address:
  • Phone: 618-305-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW123397
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: