Provider Demographics
NPI:1861787145
Name:STOLLAR, LARA (LCSW)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:STOLLAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 HARRISON AVE UNIT N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2815
Mailing Address - Country:US
Mailing Address - Phone:513-981-4242
Mailing Address - Fax:513-347-5050
Practice Address - Street 1:6507 HARRISON AVE UNIT N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2815
Practice Address - Country:US
Practice Address - Phone:513-981-4242
Practice Address - Fax:513-347-5050
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA680341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health