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NPI Code Detail

MEDICARE: MRS. SVIDLANA LAWLESS ASW

MEDICARE: MRS. SVIDLANA LAWLESS ASW
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
1101YP2500XProfessional Counselor92452CA

General Provider Information

NPI Number : 1457471278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SVIDLANA LAWLESS ASW
Provider Business Mailing Address
First Line : 1001 NEEDHAM ST
Second Line :
City : MODESTO
State : CA
Zip : 95354-0730
Country : US
Telephone Number : 209-569-0373
Fax Number :
Provider Business Practice Location Address
First Line : 1001 NEEDHAM ST
Second Line :
City : MODESTO
State : CA
Zip : 95354-0730
Country : US
Telephone Number : 209-569-0373
Fax Number : 209-529-8519
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 08/21/2023

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1891810925 — MRS. TERESA A GONZALEZ COUNSELOR
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Directions to “ MRS. SVIDLANA LAWLESS ASW” Practice Location

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