Provider Demographics
NPI:1013353945
Name:LARAMORE, LYNDIE (LMHC)
Entity Type:Individual
Prefix:
First Name:LYNDIE
Middle Name:
Last Name:LARAMORE
Suffix:
Gender:F
Credentials:LMHC
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 1020
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01568-6020
Mailing Address - Country:US
Mailing Address - Phone:508-298-8237
Mailing Address - Fax:
Practice Address - Street 1:675 MAIN ST
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-0602
Practice Address - Country:US
Practice Address - Phone:774-405-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-19
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9510101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor