Provider Demographics
NPI:1992307425
Name:DUCHARME, LAURA (LSWA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:F
Credentials:LSWA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:DUCHARME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1269 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3099
Mailing Address - Country:US
Mailing Address - Phone:978-287-7951
Mailing Address - Fax:978-287-7876
Practice Address - Street 1:35 FOREST RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3844
Practice Address - Country:US
Practice Address - Phone:979-287-7800
Practice Address - Fax:978-287-7950
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA933282104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker