Provider Demographics
NPI:1891839338
Name:SOKOLSKY, LAURIE DEBRA (PSYD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:DEBRA
Last Name:SOKOLSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2605
Mailing Address - Country:US
Mailing Address - Phone:617-441-0954
Mailing Address - Fax:
Practice Address - Street 1:131 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2605
Practice Address - Country:US
Practice Address - Phone:617-441-0954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6760103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWO5369OtherBLUE CROSS BLUE SHIELD
MA402130OtherTUFTS HEALTH PLAN
MA402130OtherTUFTS HEALTH PLAN