Provider Demographics
NPI:1932653094
Name:LAFOREST, LUBENJI DANIELLE
Entity Type:Individual
Prefix:
First Name:LUBENJI
Middle Name:DANIELLE
Last Name:LAFOREST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUBENJI
Other - Middle Name:DANIELLE
Other - Last Name:LAFOREST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:165 MAIN ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1584
Mailing Address - Country:US
Mailing Address - Phone:617-903-0158
Mailing Address - Fax:
Practice Address - Street 1:165 MAIN ST UNIT 303
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1584
Practice Address - Country:US
Practice Address - Phone:617-923-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-06
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical