Healthcare Provider Details

I. General information

NPI: 1376422691
Provider Name (Legal Business Name): LAUREN ELIZABETH HARMER M.A., CF-SLP, TSSLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 HAWKINS AVE
RONKONKOMA NY
11779-2375
US

IV. Provider business mailing address

6 WICKS RD
EAST NORTHPORT NY
11731-6536
US

V. Phone/Fax

Practice location:
  • Phone: 631-240-3579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: