Provider Demographics
NPI:1346563004
Name:LAWRENCE PINCUS & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LAWRENCE PINCUS & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCUS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LMFT, LC
Authorized Official - Phone:219-395-6398
Mailing Address - Street 1:836 SOUTH 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2903
Mailing Address - Country:US
Mailing Address - Phone:219-395-6398
Mailing Address - Fax:219-728-1860
Practice Address - Street 1:601 FRANKLIN STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360
Practice Address - Country:US
Practice Address - Phone:219-877-4772
Practice Address - Fax:219-728-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002419A104100000X
IN35000684A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty