Provider Demographics
NPI:1700654175
Name:SWEITZER, LAUREN MARTHA (PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARTHA
Last Name:SWEITZER
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 1:48 N MAPLE AVE UNIT 309
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3282
Mailing Address - Country:US
Mailing Address - Phone:203-246-3848
Mailing Address - Fax:
Practice Address - Street 1:48 N MAPLE AVE UNIT 309
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3282
Practice Address - Country:US
Practice Address - Phone:203-246-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68-P123960-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty