Provider Demographics
NPI:1609302033
Name:GOLDSTEIN, LAURA (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:GOLDSTEIN
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 1:225 BROADWAY STE 2070
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3260
Mailing Address - Country:US
Mailing Address - Phone:212-227-4343
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:SUITE 2070
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-4810
Practice Address - Country:US
Practice Address - Phone:917-768-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099981104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker