Provider Demographics
NPI:1043983273
Name:LAYUGAN, LORI BETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:BETH
Last Name:LAYUGAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OLD COLONY WAY APT A5
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653-3234
Mailing Address - Country:US
Mailing Address - Phone:303-907-9721
Mailing Address - Fax:
Practice Address - Street 1:325 WOOD RD STE 210
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2427
Practice Address - Country:US
Practice Address - Phone:781-356-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2249581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical