Provider Demographics
NPI:1801032545
Name:ADAMSON, LAURIE (EDD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GOULD ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-5117
Mailing Address - Country:US
Mailing Address - Phone:781-662-6028
Mailing Address - Fax:
Practice Address - Street 1:12 GOULD ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-5117
Practice Address - Country:US
Practice Address - Phone:781-662-6028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6079103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000W05116OtherBCBSMA