Healthcare Provider Details

I. General information

NPI: 1154789816
Provider Name (Legal Business Name): NICOLE LAMARIANA MA, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 N COUNTRY RD
MOUNT SINAI NY
11766-1501
US

IV. Provider business mailing address

47 N COUNTRY RD
MOUNT SINAI NY
11766-1501
US

V. Phone/Fax

Practice location:
  • Phone: 631-921-3257
  • Fax:
Mailing address:
  • Phone: 631-921-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number090662
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number095663-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: