Provider Demographics
NPI:1508234774
Name:STEIN, LAUREN GREENBAUM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:GREENBAUM
Last Name:STEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 W 239TH ST
Mailing Address - Street 2:APT 5J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1246
Mailing Address - Country:US
Mailing Address - Phone:917-885-2835
Mailing Address - Fax:
Practice Address - Street 1:699 W 239TH ST
Practice Address - Street 2:APT 5J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1246
Practice Address - Country:US
Practice Address - Phone:917-885-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021368103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent