Provider Demographics
NPI:1275644858
Name:MCBAIN, LAURIE ANNE (CSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ANNE
Last Name:MCBAIN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 MCCULLOUGH PL
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-3718
Mailing Address - Country:US
Mailing Address - Phone:518-376-3402
Mailing Address - Fax:518-479-4090
Practice Address - Street 1:726 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-2215
Practice Address - Country:US
Practice Address - Phone:518-376-3402
Practice Address - Fax:518-479-4090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY51687-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health