Provider Demographics
NPI:1013352095
Name:LUND, J. MICHELLE (BS, MA, MSW)
Entity Type:Individual
Prefix:
First Name:J.
Middle Name:MICHELLE
Last Name:LUND
Suffix:
Gender:F
Credentials:BS, MA, MSW
Other - Prefix:
Other - First Name:JEANICE
Other - Middle Name:MICHELLE
Other - Last Name:MEDLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 GROVER RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-2510
Mailing Address - Country:US
Mailing Address - Phone:781-254-8952
Mailing Address - Fax:
Practice Address - Street 1:32 GROVER RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-2510
Practice Address - Country:US
Practice Address - Phone:781-254-8952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker