Provider Demographics
NPI:1942953757
Name:LAUBE, JAMIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:LAUBE
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 1:504 E MOORE LOOP APT A
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996-1232
Mailing Address - Country:US
Mailing Address - Phone:775-721-1323
Mailing Address - Fax:
Practice Address - Street 1:504 E MOORE LOOP APT A
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996-1232
Practice Address - Country:US
Practice Address - Phone:775-721-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099279261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty