Healthcare Provider Details

I. General information

NPI: 1760831309
Provider Name (Legal Business Name): NATASHA LAZARTES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2016
Last Update Date: 06/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W 58TH ST SUITE 508
NEW YORK NY
10019-1827
US

IV. Provider business mailing address

2747 STRICKLAND AVE
BROOKLYN NY
11234-6428
US

V. Phone/Fax

Practice location:
  • Phone: 347-497-8136
  • Fax:
Mailing address:
  • Phone: 347-497-8136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001285-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: