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Individual
MS. MADELEINE LOURIE
Active
Individual
MS. MADELEINE LOURIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1019548
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007155108
AETNA BEHAVIORAL HEALTH
MA
01
—
P05823
BLUECROSSBLUESHIELD
MA
01
—
P1058486
OXFORD USA
MA
Enumeration date
10/23/2006
Last updated
07/08/2007
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