Provider Demographics
NPI:1093168585
Name:LCT THERAPY
Entity Type:Organization
Organization Name:LCT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISBELT
Authorized Official - Middle Name:CARMEN
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:347-528-5592
Mailing Address - Street 1:672 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-2445
Mailing Address - Country:US
Mailing Address - Phone:347-528-5592
Mailing Address - Fax:
Practice Address - Street 1:672 CENTER AVE
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2445
Practice Address - Country:US
Practice Address - Phone:347-528-5592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013953-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services