Provider Demographics
NPI:1194755496
Name:LEFEBVRE, TRUDY M (LICSW)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:M
Last Name:LEFEBVRE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NEVADA RD
Mailing Address - Street 2:
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-2358
Mailing Address - Country:US
Mailing Address - Phone:978-649-9140
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:ENRM VA HOSPITAL SOCIAL WORK SERVICES
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01879
Practice Address - Country:US
Practice Address - Phone:731-689-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1135931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical