Provider Demographics
NPI:1801106554
Name:MUSCARA, LORI ROSE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ROSE
Last Name:MUSCARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ROSE
Other - Last Name:RAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:580 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6000
Mailing Address - Country:US
Mailing Address - Phone:631-482-9845
Mailing Address - Fax:631-669-8763
Practice Address - Street 1:580 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6000
Practice Address - Country:US
Practice Address - Phone:516-287-0589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0845071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical