Provider Demographics
NPI:1124153168
Name:COHEN LAUB, ESTEE SARAH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ESTEE
Middle Name:SARAH
Last Name:COHEN LAUB
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 1:24 SEDGEWICK LANE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790
Mailing Address - Country:US
Mailing Address - Phone:631-689-9365
Mailing Address - Fax:631-757-3929
Practice Address - Street 1:24 SEDGEWICK LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3106
Practice Address - Country:US
Practice Address - Phone:631-689-9365
Practice Address - Fax:631-757-3929
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03642411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical