MEDICARE: LARA COGLIANO THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1174473946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARA COGLIANO THOMPSON

Provider Business Mailing Address
First Line	:	62 DERBY ST STE 15
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-3718
Country	:	US
Telephone Number	:	978-618-8597
Fax Number	:	781-740-8212

Provider Business Practice Location Address
First Line	:	62 DERBY ST STE 15
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-3718
Country	:	US
Telephone Number	:	978-618-8597
Fax Number	:	781-740-8212

Authorized Official
Title or Position	:	LICSW
Name	:	LARA THOMPSON
Credential	:
Telephone Number	:	978-618-8597

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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