Provider Demographics
NPI:1407005242
Name:O'MEARA, LAURA (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:
Last Name:O'MEARA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 UNION ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1348
Mailing Address - Country:US
Mailing Address - Phone:781-268-2200
Mailing Address - Fax:781-268-0465
Practice Address - Street 1:270 UNION ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1348
Practice Address - Country:US
Practice Address - Phone:781-268-2200
Practice Address - Fax:781-268-0465
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10256761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical