Provider Demographics
NPI:1750098406
Name:LAWRENCE, GEORGETTE (LMSW)
Entity type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 COOP CITY BLVD
Mailing Address - Street 2:23C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475
Mailing Address - Country:US
Mailing Address - Phone:914-885-5565
Mailing Address - Fax:
Practice Address - Street 1:1332 FULTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2404
Practice Address - Country:US
Practice Address - Phone:718-378-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094241-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker