Provider Demographics
NPI:1518505445
Name:LAZAREV, OLESYA (LMSW)
Entity Type:Individual
Prefix:
First Name:OLESYA
Middle Name:
Last Name:LAZAREV
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 1:1539 BATH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3820
Mailing Address - Country:US
Mailing Address - Phone:917-328-8175
Mailing Address - Fax:
Practice Address - Street 1:1539 BATH AVE APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3820
Practice Address - Country:US
Practice Address - Phone:917-328-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health