Provider Demographics
NPI:1861831448
Name:DUFFY, LAUREN A (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 BOSTON TPKE STE 3
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3871
Mailing Address - Country:US
Mailing Address - Phone:508-552-9862
Mailing Address - Fax:508-552-9703
Practice Address - Street 1:298 BOSTON TPKE STE 3
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3871
Practice Address - Country:US
Practice Address - Phone:508-552-9862
Practice Address - Fax:508-552-9703
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9621101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA22220002001OtherBLUE CROSS BLUE SHEILD
MAM18684OtherBLUE CROSS BLUE SHEILD
MA1306421Medicaid
MA1308785Medicaid
MAY10400Medicare PIN