Provider Demographics
NPI:1033349568
Name:NEVINS, LORI SPERLING (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:SPERLING
Last Name:NEVINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:SPERLING
Other - Last Name:NEVINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:28A BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2610
Mailing Address - Country:US
Mailing Address - Phone:917-861-1459
Mailing Address - Fax:203-629-0081
Practice Address - Street 1:28A BUTLER ST
Practice Address - Street 2:
Practice Address - City:COS COB
Practice Address - State:CT
Practice Address - Zip Code:06807-2610
Practice Address - Country:US
Practice Address - Phone:917-861-1459
Practice Address - Fax:203-629-0081
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0069531041C0700X
NYR047142-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical