Provider Demographics
NPI:1881147270
Name:LAURIA, LYNN MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:LAURIA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 RED TAIL RD STE 11A
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1582
Mailing Address - Country:US
Mailing Address - Phone:716-770-5010
Mailing Address - Fax:
Practice Address - Street 1:240 RED TAIL RD STE 11A
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1582
Practice Address - Country:US
Practice Address - Phone:716-770-5010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1881147270Medicaid