Provider Demographics
NPI:1407929292
Name:LAKIS, MARIA ANNE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANNE
Last Name:LAKIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W 93RD ST APT 8E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-9305
Mailing Address - Country:US
Mailing Address - Phone:212-663-3911
Mailing Address - Fax:
Practice Address - Street 1:386 PARK AVE S STE 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8804
Practice Address - Country:US
Practice Address - Phone:212-481-2500
Practice Address - Fax:212-481-8157
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07176211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical