Provider Demographics
NPI:1245814714
Name:MANDEL, LAUREN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:MANDEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LEORA
Other - Middle Name:
Other - Last Name:MANDEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1722 HIMROD ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1722 HIMROD ST APT 1R
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1413
Practice Address - Country:US
Practice Address - Phone:917-818-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099230-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical