Provider Demographics
NPI:1447305487
Name:LURIE, MARILYN ESTHER (LCSW LICENSED CLINIC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:ESTHER
Last Name:LURIE
Suffix:
Gender:F
Credentials:LCSW LICENSED CLINIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 EAST 68TH STREET
Mailing Address - Street 2:SUITE #2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-535-8435
Mailing Address - Fax:212-397-4255
Practice Address - Street 1:7 EAST 68TH STREET
Practice Address - Street 2:SUITE #2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-535-8435
Practice Address - Fax:212-397-4255
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO168841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111659OtherVALUE OPTIONS
NY0023148OtherGHI