Provider Demographics
NPI:1538397229
Name:LAWLOR, EILEEN M (LICSW)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 633
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:MA
Mailing Address - Zip Code:01245
Mailing Address - Country:US
Mailing Address - Phone:413-528-7916
Mailing Address - Fax:
Practice Address - Street 1:52 HUPI RD.
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:MA
Practice Address - Zip Code:01245
Practice Address - Country:US
Practice Address - Phone:413-528-7916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000184101YA0400X
MA107471104100000X
CT002576104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)