Provider Demographics
NPI:1558926600
Name:HEATHER LORTIE LCSW PLLC
Entity Type:Organization
Organization Name:HEATHER LORTIE LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LORTIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-748-5340
Mailing Address - Street 1:2 WASHINGTON SQUARE VLG APT 14G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1709
Mailing Address - Country:US
Mailing Address - Phone:917-748-5340
Mailing Address - Fax:
Practice Address - Street 1:594 BROADWAY RM 907
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3289
Practice Address - Country:US
Practice Address - Phone:917-748-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty