Provider Demographics
NPI:1528017597
Name:MAHEU, LAURIE HELEN
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:HELEN
Last Name:MAHEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:HELEN RAYMOND
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:585 UNION AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2504
Mailing Address - Country:US
Mailing Address - Phone:603-337-5938
Mailing Address - Fax:
Practice Address - Street 1:585 UNION AVE STE 5
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2504
Practice Address - Country:US
Practice Address - Phone:603-337-5938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC9859104100000X
NH16391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1528017597OtherANTHEM BLUE CROSS BLUE SHIELD
ME431870399Medicaid
1528017597OtherCIGNA
1528017597OtherMULTIPLAN
NH3091178Medicaid