Provider Demographics
NPI:1700350568
Name:PACKARD, LAURA JEAN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:PACKARD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BEEDEN RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-1146
Mailing Address - Country:US
Mailing Address - Phone:774-955-1030
Mailing Address - Fax:
Practice Address - Street 1:33 BEEDEN RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-1146
Practice Address - Country:US
Practice Address - Phone:774-955-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor