Provider Demographics
NPI:1740245315
Name:MENARD, JOHN D (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:MENARD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 WARD ST
Mailing Address - Street 2:APT 2
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610
Mailing Address - Country:US
Mailing Address - Phone:508-754-2923
Mailing Address - Fax:
Practice Address - Street 1:89 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1482
Practice Address - Country:US
Practice Address - Phone:413-297-6968
Practice Address - Fax:413-297-6968
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
MA4914101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1740245315OtherLMHC