Provider Demographics
NPI:1952916900
Name:LAURA NATHANSON LICENSED MENTAL HEALTH COUNSELOR PLLC
Entity Type:Organization
Organization Name:LAURA NATHANSON LICENSED MENTAL HEALTH COUNSELOR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-720-8409
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-0004
Mailing Address - Country:US
Mailing Address - Phone:917-720-8409
Mailing Address - Fax:877-224-9708
Practice Address - Street 1:1607 ROUTE 300
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1738
Practice Address - Country:US
Practice Address - Phone:917-720-8409
Practice Address - Fax:877-224-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty