Individual
LAURIE COSTIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D; LMHC
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4052
MA
103T00000X
Psychologist
Primary
9242
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301071
—
MA
Enumeration date
04/13/2006
Last updated
12/20/2011
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