Healthcare Provider Details

I. General information

NPI: 1609612704
Provider Name (Legal Business Name): LAUREN MILO MENTAL HEALTH COUNSELOR, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 BROADWAY APT 3G
NEW YORK NY
10010-0007
US

IV. Provider business mailing address

1107 BROADWAY APT 3G
NEW YORK NY
10010-0007
US

V. Phone/Fax

Practice location:
  • Phone: 516-574-9152
  • Fax:
Mailing address:
  • Phone: 516-574-9152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREN MILO
Title or Position: MEMBER
Credential: LMHC
Phone: 516-574-9152