Healthcare Provider Details

I. General information

NPI: 1245172956
Provider Name (Legal Business Name): LAUREN MONROE MS, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 HALLOCK AVE
PORT JEFFERSON STATION NY
11776-1217
US

IV. Provider business mailing address

7 VALLEY CT
MOUNT SINAI NY
11766-1728
US

V. Phone/Fax

Practice location:
  • Phone: 516-247-9187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2592144
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: