Provider Demographics
NPI:1518014133
Name:AVERY, LAUREN MURPHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MURPHY
Last Name:AVERY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MUZZEY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5209
Mailing Address - Country:US
Mailing Address - Phone:617-407-3092
Mailing Address - Fax:781-369-1577
Practice Address - Street 1:15 MUZZEY ST STE 3
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5209
Practice Address - Country:US
Practice Address - Phone:617-407-3092
Practice Address - Fax:781-369-1577
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2009-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7726103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical