Provider Demographics
NPI:1225442874
Name:CONOVER, LAURIE BETH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:BETH
Last Name:CONOVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:BETH
Other - Last Name:MORASCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2209 GENESEE STREET
Mailing Address - Street 2:BUSINESS OFFICE ROOM 310
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501
Mailing Address - Country:US
Mailing Address - Phone:315-801-3282
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:1676 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502
Practice Address - Country:US
Practice Address - Phone:315-624-5241
Practice Address - Fax:315-624-5442
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730835441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical