Provider Demographics
NPI:1972550853
Name:LAP, INA LOUISE (MSW)
Entity type:Individual
Prefix:
First Name:INA
Middle Name:LOUISE
Last Name:LAP
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GALAHAD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655-1314
Mailing Address - Country:US
Mailing Address - Phone:508-274-6175
Mailing Address - Fax:508-790-3378
Practice Address - Street 1:23 BAYSTATE CT #25
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631
Practice Address - Country:US
Practice Address - Phone:508-274-6175
Practice Address - Fax:508-240-5448
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1020757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP06173Medicare ID - Type Unspecified