Provider Demographics
NPI:1992358576
Name:LAMOTHE, LUCIENNE (FNP, PMHNP)
Entity type:Individual
Prefix:
First Name:LUCIENNE
Middle Name:
Last Name:LAMOTHE
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAZZEO DR STE 201J
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3433
Mailing Address - Country:US
Mailing Address - Phone:508-419-0990
Mailing Address - Fax:954-405-8874
Practice Address - Street 1:10 MAZZEO DR STE 201J
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3433
Practice Address - Country:US
Practice Address - Phone:508-419-0990
Practice Address - Fax:954-405-8874
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2259797163WG0000X, 363LF0000X
MA2025001798363LP0808X
MAF10190728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health