Provider Demographics
NPI:1639663768
Name:LAWSON, BRANDY (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:LAWSON
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 1:1635 UNION CENTER MAINE HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1340
Mailing Address - Country:US
Mailing Address - Phone:607-205-3231
Mailing Address - Fax:607-953-0294
Practice Address - Street 1:1635 UNION CENTER MAINE HWY STE 204
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-1340
Practice Address - Country:US
Practice Address - Phone:607-205-3231
Practice Address - Fax:607-953-0294
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty