Doctor Name: | LAUREN MANASSE-LATHAM |
NPI Number: | 1013064229 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LICSW |
License Number: | 1020734 |
Business Practice Address: | 3 Thornton St Newton, MA - 024581519 |
Business Phone Number: | 6178940024 |
Business Fax Number: | |
Mailing Address: | 177 Metropolitan Ave, ROSLINDALE |
State: | MA |
Postal Code: | 021314228 |
Phone Number: | 6173639988 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1020734 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |