Provider Demographics
NPI:1770065971
Name:MCCABE, LAUREN STACIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:STACIE
Last Name:MCCABE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:STACIE
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:24 OAKFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1914
Mailing Address - Country:US
Mailing Address - Phone:516-654-4715
Mailing Address - Fax:
Practice Address - Street 1:496 SMITHTOWN BYP STE 203
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5011
Practice Address - Country:US
Practice Address - Phone:516-654-4715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0862331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical