Provider Demographics
NPI:1144534017
Name:BRYCE, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BRYCE
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 1:203 W. 12TH STREET
Mailing Address - Street 2:SOCIAL WORK DEPARTMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-0000
Mailing Address - Country:US
Mailing Address - Phone:212-604-8141
Mailing Address - Fax:212-604-1798
Practice Address - Street 1:203 W 12TH ST
Practice Address - Street 2:SUITE 1022
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7762
Practice Address - Country:US
Practice Address - Phone:212-604-8141
Practice Address - Fax:212-604-1798
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0484221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical