Provider Demographics
NPI:1508180282
Name:LAUER, KRISTY L (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:L
Last Name:LAUER
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 1:11531 DEWEY RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14129-9707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11531 DEWEY RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:NY
Practice Address - Zip Code:14129-9707
Practice Address - Country:US
Practice Address - Phone:716-560-5526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079423-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical