Provider Demographics
NPI:1881929511
Name:FIELD, LORI BETH (LCSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:BETH
Last Name:FIELD
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 1:16 LANDMARK LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1623
Mailing Address - Country:US
Mailing Address - Phone:585-613-6714
Mailing Address - Fax:
Practice Address - Street 1:435 CENTRAL PARK W
Practice Address - Street 2:APT 6P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4377
Practice Address - Country:US
Practice Address - Phone:516-965-4736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0775131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY204290534Medicaid
NY204290534Medicaid