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General NPI Number Information
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NPI Number | 1407498355
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Entity Type | Individual
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Provider Name | LAUREN BOUYEA LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 8 N MAIN ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-2282
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Country | US
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Telephone | 508-409-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 71 MESSENGER ST APT 519
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City | PLAINVILLE
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State | MA
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Zip | 02762-5056
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Country | US
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Telephone | 401-580-2086
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000225122
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License Number State | MA
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