Provider Demographics
NPI:1659670529
Name:LAGUE, MICHELLE YVONNE (LICSW)
Entity type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:YVONNE
Last Name:LAGUE
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 1:421 N MAIN ST BLDG 9A
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-9764
Mailing Address - Country:US
Mailing Address - Phone:413-320-5777
Mailing Address - Fax:413-582-3071
Practice Address - Street 1:421 N MAIN ST BLDG 9A
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:MA
Practice Address - Zip Code:01053-9764
Practice Address - Country:US
Practice Address - Phone:413-320-5777
Practice Address - Fax:413-582-3071
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1277951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical