Provider Demographics
NPI:1043920325
Name:AUSTIN, LUCIANA (MHC)
Entity Type:Individual
Prefix:
First Name:LUCIANA
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-2121
Mailing Address - Country:US
Mailing Address - Phone:617-987-7887
Mailing Address - Fax:
Practice Address - Street 1:143 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5247
Practice Address - Country:US
Practice Address - Phone:617-987-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional