Provider Demographics
NPI:1346840766
Name:LABRECQUE, KAREN MARIE (LADC1)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:LABRECQUE
Suffix:
Gender:F
Credentials:LADC1
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:MASIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC1
Mailing Address - Street 1:168 PINE ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2611
Mailing Address - Country:US
Mailing Address - Phone:978-798-5889
Mailing Address - Fax:
Practice Address - Street 1:75 LINDALL ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2121
Practice Address - Country:US
Practice Address - Phone:978-223-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19602101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)