Healthcare Provider Details

I. General information

NPI: 1912851338
Provider Name (Legal Business Name): FEDNA LAURENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 MAIN ST
SOUTH GRAFTON MA
01560-1129
US

IV. Provider business mailing address

81 HOPE AVE
WORCESTER MA
01603-2299
US

V. Phone/Fax

Practice location:
  • Phone: 508-796-0225
  • Fax:
Mailing address:
  • Phone: 774-285-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: