Provider Demographics
NPI:1720563331
Name:FREY, LAUREN LOUISE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LOUISE
Last Name:FREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2207
Mailing Address - Country:US
Mailing Address - Phone:203-500-5379
Mailing Address - Fax:
Practice Address - Street 1:37 WINTER ISLAND RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5715
Practice Address - Country:US
Practice Address - Phone:978-744-1099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117583104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker