Provider Demographics
NPI:1023179678
Name:SPRUCHMAN, LORRAINE AVA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:AVA
Last Name:SPRUCHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PLAZA STREET
Mailing Address - Street 2:C2
Mailing Address - City:BRKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-622-3282
Mailing Address - Fax:
Practice Address - Street 1:20 PLAZA STREET
Practice Address - Street 2:C2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:718-622-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01595111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical