Provider Demographics
NPI:1679562854
Name:LARIVIERE, JANINE B (LMHC)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:B
Last Name:LARIVIERE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:153 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-2307
Mailing Address - Country:US
Mailing Address - Phone:508-476-7986
Mailing Address - Fax:508-966-2072
Practice Address - Street 1:15 N MAIN ST
Practice Address - Street 2:SUITE C - 17
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-1548
Practice Address - Country:US
Practice Address - Phone:508-966-4002
Practice Address - Fax:508-966-2072
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0776OtherBLUE CROSS, MA
NYNZ791OtherEMPIRE BLUE CROSS
MA62-52249OtherUBH