Provider Demographics
NPI:1437534245
Name:UTTER, LAUREN (PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:UTTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MERRIMAC ST STE 501
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4714
Mailing Address - Country:US
Mailing Address - Phone:617-643-1204
Mailing Address - Fax:617-643-1331
Practice Address - Street 1:151 MERRIMAC ST STE 501
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4714
Practice Address - Country:US
Practice Address - Phone:617-643-1204
Practice Address - Fax:617-643-1331
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021254103TC0700X
MA10732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical