Provider Demographics
NPI:1326205196
Name:OLIVER, LAURA LEAH (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEAH
Last Name:OLIVER
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 1:15 ROUND HILL DR
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1929
Mailing Address - Country:US
Mailing Address - Phone:917-992-9986
Mailing Address - Fax:914-449-6154
Practice Address - Street 1:141 EAST 55TH STREET
Practice Address - Street 2:SUITE 9B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4032
Practice Address - Country:US
Practice Address - Phone:917-992-9986
Practice Address - Fax:914-449-6154
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07224511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical