Healthcare Provider Details

I. General information

NPI: 1982518825
Provider Name (Legal Business Name): LAUREN ANN LORELLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 HALF HOLLOW RD
DIX HILLS NY
11746-5859
US

IV. Provider business mailing address

2A BEVERLY RD
FARMINGDALE NY
11735-3335
US

V. Phone/Fax

Practice location:
  • Phone: 631-370-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100283
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: