Basic Information
| Provider Information | |||||||||
| NPI: | 1093910721 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWRENCE | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.ED., LMHC, NCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2262 | ||||||||
| Address2: | |||||||||
| City: | TAUNTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027800965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7746441622 | ||||||||
| FaxNumber: | 7813417272 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 PORTER ST | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | STOUGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020722978 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817084504 | ||||||||
| FaxNumber: | 7813417272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 09/09/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 7518 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.