Provider Demographics
NPI:1497239016
Name:LAJEUNESSE, ERIN MACDONALD (LICSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MACDONALD
Last Name:LAJEUNESSE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:182 KEARSARGE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3402
Mailing Address - Country:US
Mailing Address - Phone:617-571-3433
Mailing Address - Fax:
Practice Address - Street 1:182 KEARSARGE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3402
Practice Address - Country:US
Practice Address - Phone:617-571-3433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1144791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical