Provider Demographics
NPI:1871751578
Name:MAJKA, LAURIE ANN (MA CAGS, LMHC)
Entity type:Individual
Prefix:MISS
First Name:LAURIE
Middle Name:ANN
Last Name:MAJKA
Suffix:
Gender:F
Credentials:MA CAGS, LMHC
Other - Prefix:MISS
Other - First Name:LAURIE
Other - Middle Name:A
Other - Last Name:MAJKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CAGS, LMHC
Mailing Address - Street 1:PO BOX 1103
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-1103
Mailing Address - Country:US
Mailing Address - Phone:978-257-8595
Mailing Address - Fax:978-257-8595
Practice Address - Street 1:16 CAT ALY
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-8708
Practice Address - Country:US
Practice Address - Phone:789-257-8595
Practice Address - Fax:978-257-8595
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MA7865103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1871751578Medicaid