Provider Demographics
NPI:1285185603
Name:FIEDLER, LAUREN BAIRD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:BAIRD
Last Name:FIEDLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4022
Mailing Address - Country:US
Mailing Address - Phone:971-219-3274
Mailing Address - Fax:
Practice Address - Street 1:667 STONELEIGH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:856-279-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
NY021888103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist