Provider Demographics
NPI:1619112505
Name:LUCIA, COLLEEN MURPHY (LICSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MURPHY
Last Name:LUCIA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 EAST WASHINTON ST
Mailing Address - Street 2:
Mailing Address - City:NO. ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3143
Mailing Address - Country:US
Mailing Address - Phone:742-542-9387
Mailing Address - Fax:508-236-8903
Practice Address - Street 1:500 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6301
Practice Address - Country:US
Practice Address - Phone:774-254-2938
Practice Address - Fax:508-236-8903
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215383101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid