Provider Demographics
NPI:1508571779
Name:LAUREN LOGOZIO, LCSW LLC
Entity Type:Organization
Organization Name:LAUREN LOGOZIO, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGOZIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-355-5422
Mailing Address - Street 1:11 ISLAND HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4007
Mailing Address - Country:US
Mailing Address - Phone:631-355-5422
Mailing Address - Fax:
Practice Address - Street 1:109 DANBURY RD STE D7
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4142
Practice Address - Country:US
Practice Address - Phone:203-694-0628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285980458OtherNPI