Provider Demographics
NPI:1366540643
Name:HARTWELL, LORRAINE J
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:J
Last Name:HARTWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MILBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527
Mailing Address - Country:US
Mailing Address - Phone:508-876-3223
Mailing Address - Fax:508-876-3224
Practice Address - Street 1:29 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527
Practice Address - Country:US
Practice Address - Phone:508-876-3223
Practice Address - Fax:508-876-3224
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA591LADACI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18684OtherBCBS
MA1308785OtherMCD MH
MA1306421Medicaid
MAM18684OtherBCBS