Provider Demographics
NPI:1619218682
Name:LAWRENCE, CORINNE NIOBE (LMHC)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:NIOBE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CATON AVE
Mailing Address - Street 2:APT 4L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1001
Mailing Address - Country:US
Mailing Address - Phone:347-984-1969
Mailing Address - Fax:
Practice Address - Street 1:260 BROADWAY
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-8433
Practice Address - Country:US
Practice Address - Phone:347-505-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP85048101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health