Provider Demographics
NPI:1679798599
Name:LEDBETTER, LAUREN CARTER (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CARTER
Last Name:LEDBETTER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2504
Mailing Address - Country:US
Mailing Address - Phone:617-997-6594
Mailing Address - Fax:
Practice Address - Street 1:TEN MILK STREET
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108
Practice Address - Country:US
Practice Address - Phone:617-643-0952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2139101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical