Provider Demographics
NPI:1093931404
Name:DYCHE, LAWRENCE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:DYCHE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WESTGATE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2207
Mailing Address - Country:US
Mailing Address - Phone:718-920-6788
Mailing Address - Fax:718-515-5416
Practice Address - Street 1:7 WESTGATE CT
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2207
Practice Address - Country:US
Practice Address - Phone:718-920-6788
Practice Address - Fax:718-515-5416
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR008398-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical