Healthcare Provider Details

I. General information

NPI: 1619885670
Provider Name (Legal Business Name): CLEMENTINE SB LAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

37 BRIDGE ST PO BOX 164
NORTHAMPTON MA
01060
US

IV. Provider business mailing address

37 BRIDGE ST PO BOX 164
NORTHAMPTON MA
01060
US

V. Phone/Fax

Practice location:
  • Phone: 857-231-1590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: