Provider Demographics
NPI:1326657487
Name:BATTLE, LAQUEEN ARLEEN (NCMA)
Entity Type:Individual
Prefix:
First Name:LAQUEEN
Middle Name:ARLEEN
Last Name:BATTLE
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ARCH STREET
Mailing Address - Street 2:8TH FLOOR, STE 869
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110
Mailing Address - Country:US
Mailing Address - Phone:857-353-0173
Mailing Address - Fax:
Practice Address - Street 1:101 ARCH STREET
Practice Address - Street 2:8TH FLOOR, STE 869
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110
Practice Address - Country:US
Practice Address - Phone:857-353-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000000101YM0800X
NY0000000101YM0800X
NY834023171W00000X, 364SC1501X, 364SP0812X, 172V00000X
MA009CSL6207PE0004X
NY00ABAE62083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171W00000XOther Service ProvidersContractor
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Community