Provider Demographics
NPI:1437880788
Name:DOUBLEDAY, LIEN
Entity Type:Individual
Prefix:
First Name:LIEN
Middle Name:
Last Name:DOUBLEDAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 UNION ST STE G02
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1138
Mailing Address - Country:US
Mailing Address - Phone:508-556-0745
Mailing Address - Fax:
Practice Address - Street 1:51 UNION ST STE G02
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1138
Practice Address - Country:US
Practice Address - Phone:508-556-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health