Provider Demographics
NPI:1861374035
Name:LAUTURE, TANEISHA AUDIE-ANN
Entity type:Individual
Prefix:
First Name:TANEISHA
Middle Name:AUDIE-ANN
Last Name:LAUTURE
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 1:191 LIBERTY CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:PINE ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10969-1618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:191 LIBERTY CORNERS RD
Practice Address - Street 2:
Practice Address - City:PINE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10969-1618
Practice Address - Country:US
Practice Address - Phone:240-374-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator