Provider Demographics
NPI:1275661167
Name:LUSSIER, LAUREN ROSE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ROSE
Last Name:LUSSIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1D PATRIOTS WAY
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-2370
Mailing Address - Country:US
Mailing Address - Phone:978-422-0588
Mailing Address - Fax:
Practice Address - Street 1:286 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2106
Practice Address - Country:US
Practice Address - Phone:508-753-2967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health