Healthcare Provider Details

I. General information

NPI: 1780597062
Provider Name (Legal Business Name): LAURA BROWN-RIVERA, LCSW, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 GRANT AVE
BAY SHORE NY
11706-1008
US

IV. Provider business mailing address

418 BROADWAY STE R
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 646-856-9454
  • Fax:
Mailing address:
  • Phone: 646-856-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA BROWN-RIVERA
Title or Position: CEO
Credential: LCSW
Phone: 646-856-9454