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General NPI Number Information
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NPI Number | 1841587698
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Entity Type | Individual
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Provider Name | LAUREN W HENRY LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 295 MAIN ST S 2ND FLOOR
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City | WOODBURY
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State | CT
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Zip | 06798-3408
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Country | US
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Telephone | 917-886-9073
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WOODRUFF AVE
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City | WATERTOWN
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State | CT
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Zip | 06795-2532
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Country | US
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Telephone | 917-886-9073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8550
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 079452
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License Number State | NY
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