Provider Demographics
NPI:1992032312
Name:LAWLESS, MICHAEL (LICSW, MLADC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:LAWLESS
Suffix:
Gender:M
Credentials:LICSW, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16234
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-6234
Mailing Address - Country:US
Mailing Address - Phone:603-545-2329
Mailing Address - Fax:
Practice Address - Street 1:90 AIRPORT RD
Practice Address - Street 2:SUITE 19
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5326
Practice Address - Country:US
Practice Address - Phone:603-545-2329
Practice Address - Fax:603-532-0720
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18251041C0700X
NH101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)