Provider Demographics
NPI:1134287956
Name:LAULETTA, HEATHER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:LAULETTA
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 1:3 ROY DR
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2213
Mailing Address - Country:US
Mailing Address - Phone:631-366-0919
Mailing Address - Fax:
Practice Address - Street 1:NORTHPORT VETERANS ADMINISTRATION
Practice Address - Street 2:79 MIDDLEVILLE RD.
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079704-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical