Healthcare Provider Details

I. General information

NPI: 1053201566
Provider Name (Legal Business Name): LAURA KATHERINE VAN VORIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE STE 3
TROY NY
12180-3410
US

IV. Provider business mailing address

87 SALISBURY RD
DELMAR NY
12054-1218
US

V. Phone/Fax

Practice location:
  • Phone: 518-270-2800
  • Fax: 518-270-2707
Mailing address:
  • Phone: 518-669-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128129-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: