Provider Demographics
NPI:1396378592
Name:BERTRAND, LORRIE-MICHELLE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LORRIE-MICHELLE
Middle Name:
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GROSSMAN DR # 1108
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4967
Mailing Address - Country:US
Mailing Address - Phone:508-625-9860
Mailing Address - Fax:508-213-3832
Practice Address - Street 1:500 GROSSMAN DR # 1108
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4967
Practice Address - Country:US
Practice Address - Phone:508-625-9860
Practice Address - Fax:508-213-3832
Is Sole Proprietor?:No
Enumeration Date:2020-02-15
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2254391041C0700X
MA1251061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical