Provider Demographics
NPI:1780166355
Name:ECHAVARRIA, LUCIANA
Entity type:Individual
Prefix:
First Name:LUCIANA
Middle Name:
Last Name:ECHAVARRIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUCIANA
Other - Middle Name:
Other - Last Name:FLAVEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, PMH-C
Mailing Address - Street 1:84 W BROADWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2323
Mailing Address - Country:US
Mailing Address - Phone:978-226-8538
Mailing Address - Fax:
Practice Address - Street 1:391 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2119
Practice Address - Country:US
Practice Address - Phone:978-455-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1236101041C0700X
MA2240371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical