Provider Demographics
NPI:1003354747
Name:KHOURI, LAMA Z
Entity Type:Individual
Prefix:
First Name:LAMA
Middle Name:Z
Last Name:KHOURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E 30TH ST APT 15D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7381
Mailing Address - Country:US
Mailing Address - Phone:212-877-3407
Mailing Address - Fax:
Practice Address - Street 1:1133 BROADWAY STE 815
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8064
Practice Address - Country:US
Practice Address - Phone:212-877-3407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR086359-011041C0700X
NY0863591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical