Provider Demographics
NPI:1073589768
Name:LAMOTHE, LORRAINE ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:ANNE
Last Name:LAMOTHE
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 1:124 DAKOTA DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5866
Mailing Address - Country:US
Mailing Address - Phone:845-227-6918
Mailing Address - Fax:
Practice Address - Street 1:124 DAKOTA DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-5866
Practice Address - Country:US
Practice Address - Phone:845-227-6918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1585511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical