Healthcare Provider Details

I. General information

NPI: 1588391015
Provider Name (Legal Business Name): LAINIE MURRAY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAINIE FERGUSON

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CHAPEL PL
WELLESLEY MA
02481-3130
US

IV. Provider business mailing address

223 WESTFORD ST
CHELMSFORD MA
01824-1136
US

V. Phone/Fax

Practice location:
  • Phone: 978-364-3399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10002165
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: