Healthcare Provider Details

I. General information

NPI: 1588895510
Provider Name (Legal Business Name): LAURA MICHELLE PELTON SWEET LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2009
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 WALNUT ST STE 220
NEWTON MA
02460-1994
US

IV. Provider business mailing address

288 WALNUT ST STE 220
NEWTON MA
02460-1994
US

V. Phone/Fax

Practice location:
  • Phone: 781-551-0999
  • Fax:
Mailing address:
  • Phone: 781-551-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8679
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: