Provider Demographics
NPI:1063672368
Name:LAZNOVSKY, BRIGHTON K (LCADC)
Entity Type:Individual
Prefix:MRS
First Name:BRIGHTON
Middle Name:K
Last Name:LAZNOVSKY
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S HANSON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2920
Mailing Address - Country:US
Mailing Address - Phone:410-819-5617
Mailing Address - Fax:410-819-5691
Practice Address - Street 1:100 S HANSON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2920
Practice Address - Country:US
Practice Address - Phone:410-819-5617
Practice Address - Fax:410-819-5691
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA1803101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)