Provider Demographics
NPI:1427208792
Name:TERIO, LAURA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:TERIO
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 1:9520 63RD RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1160
Mailing Address - Country:US
Mailing Address - Phone:718-459-1225
Mailing Address - Fax:
Practice Address - Street 1:9520 63RD RD
Practice Address - Street 2:SUITE J
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1160
Practice Address - Country:US
Practice Address - Phone:718-459-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0755821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical