1003059254 NPI number — LAUREL T ASHCRAFT LMHC

Table of content: LAUREL T ASHCRAFT LMHC (NPI 1003059254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003059254 NPI number — LAUREL T ASHCRAFT LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASHCRAFT
Provider First Name:
LAUREL
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003059254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 W CUMMINGS PARK
Provider Second Line Business Mailing Address:
STE 3900
Provider Business Mailing Address City Name:
WOBURN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01801-6503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-932-8114
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
572 BOSTON RD
Provider Second Line Business Practice Location Address:
SUITE 14
Provider Business Practice Location Address City Name:
BILLERICA
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01821-3776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-330-5931
Provider Business Practice Location Address Fax Number:
978-608-4102
Provider Enumeration Date:
04/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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