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NPI Code Detail

MEDICARE: LAURA ROYSE LCSW

MEDICARE: LAURA ROYSE 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 Worker076551NY

General Provider Information

NPI Number : 1336298611
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ROYSE LCSW
Provider Business Mailing Address
First Line : 9114 37TH AVE
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7920
Country : US
Telephone Number : 718-779-1600
Fax Number : 718-396-6189
Provider Business Practice Location Address
First Line : 9114 37TH AVE
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-7920
Country : US
Telephone Number : 718-779-1600
Fax Number : 718-396-6189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 09/13/2012

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1578701793 — JEANETTE SOTO
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Directions to “ LAURA ROYSE LCSW” Practice Location

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