Provider Demographics
NPI:1720603863
Name:LAVNER, SARA (MA,NCPSYA,LP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:LAVNER
Suffix:
Gender:F
Credentials:MA,NCPSYA,LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 EASR 68TH STREET
Mailing Address - Street 2:APT. 13 S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:917-613-5237
Mailing Address - Fax:
Practice Address - Street 1:80 FITH AVENUE
Practice Address - Street 2:SUITE 1503
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:917-613-5237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000178102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty