Provider Demographics
NPI:1164563748
Name:MITCHELL, LAUREN (OTR)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:TOOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3751
Mailing Address - Country:US
Mailing Address - Phone:631-793-7055
Mailing Address - Fax:
Practice Address - Street 1:16 GINA CT
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4249
Practice Address - Country:US
Practice Address - Phone:631-758-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013342225XP0200X
NY013342-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics