Provider Demographics
NPI:1013202944
Name:VAN SCHAICK-HARMAN, LAURA ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANNE
Last Name:VAN SCHAICK-HARMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S SERVICE RD # 174
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2254
Mailing Address - Country:US
Mailing Address - Phone:631-484-9679
Mailing Address - Fax:888-972-4072
Practice Address - Street 1:414 S SERVICE RD # 174
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2254
Practice Address - Country:US
Practice Address - Phone:631-484-9679
Practice Address - Fax:888-972-4072
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019611103T00000X
NY918063103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool