Provider Demographics
NPI:1912452194
Name:LAVRIGATA, LAUREN MELISSA (PSYD, LCMHC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MELISSA
Last Name:LAVRIGATA
Suffix:
Gender:F
Credentials:PSYD, LCMHC
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:MELISSA
Other - Last Name:SALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:58 RUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2120
Mailing Address - Country:US
Mailing Address - Phone:516-509-1091
Mailing Address - Fax:
Practice Address - Street 1:58 RUTH BLVD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2120
Practice Address - Country:US
Practice Address - Phone:516-509-1091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006673-1101YM0800X
NY025878103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health