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NPI Code Detail

MEDICARE: LAURENCE E BOTNICK LCSW

MEDICARE:   LAURENCE E BOTNICK  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1033997424
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURENCE E BOTNICK LCSW
Provider Business Mailing Address
First Line : 1 KALISA WAY STE 101
Second Line :
City : PARAMUS
State : NJ
Zip : 07652-3508
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Provider Business Practice Location Address
First Line : 1517 S KRAMERIA ST
Second Line :
City : DENVER
State : CO
Zip : 80224-1978
Country : US
Telephone Number : 888-948-6789
Fax Number : 877-345-3501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2023
Last Update Date : 09/18/2023

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Directions to “ LAURENCE E BOTNICK LCSW” Practice Location

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