Provider Demographics
NPI:1508304056
Name:MACLAUCHLAN, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MACLAUCHLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ORCHARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-3715
Mailing Address - Country:US
Mailing Address - Phone:978-697-1028
Mailing Address - Fax:
Practice Address - Street 1:70 EVERETT AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2376
Practice Address - Country:US
Practice Address - Phone:617-466-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-04
Last Update Date:2017-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool