Provider Demographics
NPI:1184725160
Name:MITCHELL, LAUREE WOLIN (PHD)
Entity type:Individual
Prefix:DR
First Name:LAUREE
Middle Name:WOLIN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LAUREE
Other - Middle Name:ALICE
Other - Last Name:WOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PLAZA ST W
Mailing Address - Street 2:APT. #6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3748
Mailing Address - Country:US
Mailing Address - Phone:718-399-6852
Mailing Address - Fax:
Practice Address - Street 1:34 PLAZA ST E
Practice Address - Street 2:STE 102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5038
Practice Address - Country:US
Practice Address - Phone:718-399-6852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical