Provider Demographics
NPI:1942960810
Name:NATTER, LORI TALBERT
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:TALBERT
Last Name:NATTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:TALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:417 RIVERSIDE DR APT 9A2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7945
Mailing Address - Country:US
Mailing Address - Phone:917-692-6092
Mailing Address - Fax:
Practice Address - Street 1:417 RIVERSIDE DR APT 9A2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7945
Practice Address - Country:US
Practice Address - Phone:917-692-6092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1111511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical