Provider Demographics
NPI:1548358377
Name:LESSARD, JULIANNE (OT)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:LESSARD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 DENSLOW RD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3103
Mailing Address - Country:US
Mailing Address - Phone:413-526-9969
Mailing Address - Fax:413-526-9960
Practice Address - Street 1:300 BIRNIE AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1107
Practice Address - Country:US
Practice Address - Phone:413-526-9961
Practice Address - Fax:416-526-9960
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6490225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000035265OtherBOSTON MEDICAL HEALTH NET GROUP NO
MA043527497OtherUNITED HEALTH CARE
MA043527497OtherCIGNA GROUP NO
MA28117OtherHEALTH NEW ENGLAND
MA043527497OtherGREATWEST
MA043527497OtherNORTH REGION/TRICARE
MA690675OtherTUFTS GROUP
MA11535151OtherCAQH
MA043527OtherCONNECTICARE
MA103355100OtherDEPT OF LABOR
MA9715568Medicaid
MA0799131Medicaid
MA130006490MA01OtherANTHEM BC BS
MA972730OtherNETWORK HEALTH
MAP0242238OtherPALMETTO RR MEDICARE
MA000000035319OtherBOSTON MEDICAL HEALTH NET INDIV. NO.
MA043527497OtherCONSOLIDATED
130006490MA02OtherANTHEM BC BS
MAOT0157OtherBC BS INDIV NO.
MAY61264OtherBC BS GROUP NO
MA043527497OtherUNICARE/GIC
MA046527497OtherAETNA GROUP
MA3073494OtherCIGNA INDIVIDUAL NO.
MA494474OtherTUFTS INDIVIDUAL NO
MA7109767OtherAWETNA INDIV NO.
MA043527497OtherGREATWEST
MAPT0191Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
MA0799131Medicaid