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General NPI Number Information
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NPI Number | 1093910721
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Entity Type | Individual
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Provider Name | ALBERT EDWARD LAWRENCE III M.ED., LMHC, NCC
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 3 PORTER ST 1ST FLOOR
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City | STOUGHTON
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State | MA
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Zip | 02072-2978
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Country | US
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Telephone | 781-708-4504
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Fax | 781-341-7272
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Provider Business Mailing Address
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Address Line | PO BOX 2262
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City | TAUNTON
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State | MA
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Zip | 02780-0965
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Country | US
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Telephone | 774-644-1622
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Fax | 781-341-7272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7518
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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