Provider Demographics
NPI:1891080388
Name:FELDMAN, LAUREN S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:S
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:S
Other - Last Name:DITRAPANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:199 JERICHO TPKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2167
Mailing Address - Country:US
Mailing Address - Phone:516-488-1101
Mailing Address - Fax:516-488-1151
Practice Address - Street 1:199 JERICHO TPKE
Practice Address - Street 2:SUITE 202
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2167
Practice Address - Country:US
Practice Address - Phone:516-488-1101
Practice Address - Fax:516-488-1151
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071007-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst