Provider Demographics
NPI:1578872529
Name:SINCLAIR, LORI B (LCSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:B
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 N SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3248
Mailing Address - Country:US
Mailing Address - Phone:516-557-7172
Mailing Address - Fax:
Practice Address - Street 1:561 N SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3248
Practice Address - Country:US
Practice Address - Phone:516-557-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0810391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical