Provider Demographics
NPI:1518324011
Name:ULERY-LAFRINIERE, MARIA LYNN (CADC II)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNN
Last Name:ULERY-LAFRINIERE
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LYNN
Other - Last Name:LAFRINIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC I
Mailing Address - Street 1:1869 SKYLINE CTS
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306
Mailing Address - Country:US
Mailing Address - Phone:503-437-5843
Mailing Address - Fax:503-879-4606
Practice Address - Street 1:1050 PRICE RD SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-7314
Practice Address - Country:US
Practice Address - Phone:541-928-9681
Practice Address - Fax:541-928-5990
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-06-09174400000X
OR18-02-24174400000X
OR18-02-04101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No174400000XOther Service ProvidersSpecialist