Provider Demographics
NPI:1861739211
Name:MONTANARO, LAUREN ALICIA (LCSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALICIA
Last Name:MONTANARO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:140 ROUTE 303 STE E
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-5907
Mailing Address - Country:US
Mailing Address - Phone:845-267-2172
Mailing Address - Fax:845-268-0697
Practice Address - Street 1:140 ROUTE 303
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-5906
Practice Address - Country:US
Practice Address - Phone:845-267-2172
Practice Address - Fax:845-268-0697
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0825531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical