Provider Demographics
NPI:1588994149
Name:PALMACCIO, LAUREN KIONNE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:KIONNE
Last Name:PALMACCIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:315 ALLSTON ST
Mailing Address - Street 2:UNIT 7
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7626
Mailing Address - Country:US
Mailing Address - Phone:912-656-6177
Mailing Address - Fax:
Practice Address - Street 1:148 WALDEN ST
Practice Address - Street 2:WALDEN STREET SCHOOL
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3614
Practice Address - Country:US
Practice Address - Phone:978-369-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health