1881797272 NPI number — MS. LAURA MORRALL MSW ; LICSW

Table of content: MS. LAURA MORRALL MSW ; LICSW (NPI 1881797272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881797272 NPI number — MS. LAURA MORRALL MSW ; LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRALL
Provider First Name:
LAURA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW ; LICSW
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:
1881797272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 LITTLE FARMS RD
Provider Second Line Business Mailing Address:
(1ST FLOOR)
Provider Business Mailing Address City Name:
FRAMINGHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01701-3420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-820-6669
Provider Business Mailing Address Fax Number:
508-481-2609

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
281 PLEASANT ST.
Provider Second Line Business Practice Location Address:
(1ST FLOOR)
Provider Business Practice Location Address City Name:
FRAMINGHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01701-3420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-820-6669
Provider Business Practice Location Address Fax Number:
508-481-2609
Provider Enumeration Date:
09/07/2006

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: 1041C0700X , with the licence number:  101788 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 665741 . This is a "TUFTS GRP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 023255000 . This is a "MAGELLAN GRP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1859901 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01580 . This is a "P01580,BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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