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General NPI Number Information
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NPI Number | 1164821435
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Entity Type | Organization
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Legal Business Name | LAURA HAAS LCSW & ASSOCIATES
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 201 N DELAWARE AVE
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City | N MASSAPEQUA
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State | NY
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Zip | 11758-1869
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Country | US
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Telephone | 516-753-3691
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Fax | 516-454-0965
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Provider Business Mailing Address
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Address Line | PO BOX 1595
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City | N MASSAPEQUA
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State | NY
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Zip | 11758-0910
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Country | US
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Telephone | 516-753-3691
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Fax | 516-454-0965
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Authorized Official
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Title or Position | SOCIAL WORKER / OWNER
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Name | MS. LAURA M HAAS
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Credential | LCSW
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Telephone | 516-753-3691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R070125
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License Number State | NY
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