Healthcare Provider Details

I. General information

NPI: 1952817736
Provider Name (Legal Business Name): MICHELLE LAJOIE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 HALLOCK RD STE 3A
STONY BROOK NY
11790-3077
US

IV. Provider business mailing address

1 ROCKET CT
SELDEN NY
11784-1828
US

V. Phone/Fax

Practice location:
  • Phone: 631-551-5095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093765
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number098742-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: