Provider Demographics
NPI:1861684847
Name:ARLIN, LAURA B (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:B
Last Name:ARLIN
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 1:3 BASILL LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4317
Mailing Address - Country:US
Mailing Address - Phone:631-368-5422
Mailing Address - Fax:631-368-4475
Practice Address - Street 1:3 BASILL LN
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4317
Practice Address - Country:US
Practice Address - Phone:631-368-5422
Practice Address - Fax:631-368-4475
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0408421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN59791Medicare PIN