Provider Demographics
NPI:1043466436
Name:LAFARR, MICHAEL J JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:LAFARR
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 SOUTH ST
Mailing Address - Street 2:COUNSELING CENTER, BRANDEIS UNIVERSITY
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-2728
Mailing Address - Country:US
Mailing Address - Phone:781-736-3543
Mailing Address - Fax:
Practice Address - Street 1:415 SOUTH ST
Practice Address - Street 2:COUNSELING CENTER, BRANDEIS UNIVERSITY
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2728
Practice Address - Country:US
Practice Address - Phone:781-736-3543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling