Provider Demographics
NPI:1144432493
Name:HUSSEY, LAURA DAWN
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:DAWN
Last Name:HUSSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560
Mailing Address - Country:US
Mailing Address - Phone:203-962-1242
Mailing Address - Fax:
Practice Address - Street 1:1025 NORTHERN BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:203-962-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker