Provider Demographics
NPI:1164771549
Name:LAPERLE, MIRANDA (LMHC)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:LAPERLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1518
Mailing Address - Country:US
Mailing Address - Phone:978-335-8025
Mailing Address - Fax:
Practice Address - Street 1:143 POTTLE RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-3362
Practice Address - Country:US
Practice Address - Phone:207-783-4663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12357-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health