Provider Demographics
NPI:1295067791
Name:LAWRENCE-SPEAR, MEGHAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:
Last Name:LAWRENCE-SPEAR
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 1:1935 MCGRAW AVE
Mailing Address - Street 2:APT 4C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7976
Mailing Address - Country:US
Mailing Address - Phone:646-283-2405
Mailing Address - Fax:
Practice Address - Street 1:130 E 101ST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6106
Practice Address - Country:US
Practice Address - Phone:212-534-8596
Practice Address - Fax:212-860-8407
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077174-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical