Provider Demographics
NPI:1841221611
Name:GEORGE, LAWRENCE M (LSW)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:GEORGE
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3116
Mailing Address - Country:US
Mailing Address - Phone:717-391-9974
Mailing Address - Fax:
Practice Address - Street 1:28190 WILLOW ST PIKE
Practice Address - Street 2:LIFE SPAN PSYCHOLOGICAL SERVICES PC
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584
Practice Address - Country:US
Practice Address - Phone:717-464-1464
Practice Address - Fax:717-464-4348
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA SW 1232101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical