Provider Demographics
NPI:1366455768
Name:MCLARTY, LAURA SUE (LCSW, CASAC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:SUE
Last Name:MCLARTY
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E 92ND ST
Mailing Address - Street 2:#3W
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5452
Mailing Address - Country:US
Mailing Address - Phone:212-289-6465
Mailing Address - Fax:
Practice Address - Street 1:244 5TH AVE
Practice Address - Street 2:SUITE 8E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7604
Practice Address - Country:US
Practice Address - Phone:212-539-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058788-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker