Provider Demographics
NPI:1518958438
Name:EPSTEIN, LAWRENCE DAVID (LCSW R)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:DAVID
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 SUGAR TOMS LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1150
Mailing Address - Country:US
Mailing Address - Phone:516-922-9177
Mailing Address - Fax:516-922-9177
Practice Address - Street 1:124 SUGAR TOMS LN
Practice Address - Street 2:
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1150
Practice Address - Country:US
Practice Address - Phone:516-922-9177
Practice Address - Fax:516-922-9177
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0261361104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPR0261361OtherLICENSE