Provider Demographics
NPI:1225465115
Name:NERATKO, LAURA LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNN
Last Name:NERATKO
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 1:138 WEST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:BROCTON
Mailing Address - State:NY
Mailing Address - Zip Code:14716
Mailing Address - Country:US
Mailing Address - Phone:716-792-2140
Mailing Address - Fax:
Practice Address - Street 1:138 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:BROCTON
Practice Address - State:NY
Practice Address - Zip Code:14716
Practice Address - Country:US
Practice Address - Phone:716-792-2140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081018-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical