Provider Demographics
NPI:1477605616
Name:DEMERS-GENDREAU, CLAUDETTE A (LMHC 3781)
Entity Type:Individual
Prefix:DR
First Name:CLAUDETTE
Middle Name:A
Last Name:DEMERS-GENDREAU
Suffix:
Gender:F
Credentials:LMHC 3781
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 TAUNTON GREEN
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780
Mailing Address - Country:US
Mailing Address - Phone:508-824-5045
Mailing Address - Fax:
Practice Address - Street 1:39 TAUNTON GREEN
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-824-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0396OtherBCBS
MA6269424OtherUBH