Provider Demographics
NPI:1811068968
Name:LESSER, JOAN GRANUCCI (LICSW, PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:GRANUCCI
Last Name:LESSER
Suffix:
Gender:M
Credentials:LICSW, PHD
Other - Prefix:
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Mailing Address - Street 1:51 GREENWICH RD
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1224
Mailing Address - Country:US
Mailing Address - Phone:413-567-5952
Mailing Address - Fax:413-536-7254
Practice Address - Street 1:1236 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5370
Practice Address - Country:US
Practice Address - Phone:413-533-4546
Practice Address - Fax:413-536-7254
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1073951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical