Provider Demographics
NPI:1295889749
Name:LAU, JANET LEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEE
Last Name:LAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:CRISTANDO LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 OCEAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-2109
Mailing Address - Country:US
Mailing Address - Phone:631-363-8323
Mailing Address - Fax:631-363-2054
Practice Address - Street 1:7 OCEAN AVENUE
Practice Address - Street 2:
Practice Address - City:BLUE POINT
Practice Address - State:NY
Practice Address - Zip Code:11715-2109
Practice Address - Country:US
Practice Address - Phone:631-363-8323
Practice Address - Fax:631-363-2054
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR04391211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical