Provider Demographics
NPI:1861813636
Name:BEYER, LORI A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:BEYER
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 1:144 CONOVER ST APT 4R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-1132
Mailing Address - Country:US
Mailing Address - Phone:917-392-8853
Mailing Address - Fax:
Practice Address - Street 1:144 CONOVER ST APT 4R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-1132
Practice Address - Country:US
Practice Address - Phone:917-392-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-22
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090534-1104100000X
NY0870851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker