Provider Demographics
NPI:1912414723
Name:LAWRENCE, CARLA DENISE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:DENISE
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 1:247 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-2731
Mailing Address - Country:US
Mailing Address - Phone:516-902-0135
Mailing Address - Fax:516-483-7317
Practice Address - Street 1:247 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2731
Practice Address - Country:US
Practice Address - Phone:516-902-0135
Practice Address - Fax:516-483-7317
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066233-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker