Provider Demographics
NPI:1619170503
Name:LESSER, LAUREN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:LESSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 BROADWAY
Mailing Address - Street 2:APT 3E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2831
Mailing Address - Country:US
Mailing Address - Phone:212-678-6268
Mailing Address - Fax:
Practice Address - Street 1:1 CHRISTOPHER ST
Practice Address - Street 2:1-A
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10014
Practice Address - Country:US
Practice Address - Phone:212-678-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
NYR038755-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02378361Medicaid