Provider Demographics
NPI:1881314037
Name:LINN, LAUREN ALYSSA (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALYSSA
Last Name:LINN
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 1:580 5TH AVE STE 820
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4762
Mailing Address - Country:US
Mailing Address - Phone:929-399-9653
Mailing Address - Fax:
Practice Address - Street 1:3320 PARK AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-4352
Practice Address - Country:US
Practice Address - Phone:609-576-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1119031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical