MEDICARE: MRS. LORRAINE ANNE LAMOTHE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	158551	NY

General Provider Information

NPI Number	:	1073589768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORRAINE ANNE LAMOTHE LCSW

Provider Business Mailing Address
First Line	:	124 DAKOTA DR
Second Line	:
City	:	HOPEWELL JCT
State	:	NY
Zip	:	12533-5866
Country	:	US
Telephone Number	:	845-227-6918
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 DAKOTA DR
Second Line	:
City	:	HOPEWELL JCT
State	:	NY
Zip	:	12533-5866
Country	:	US
Telephone Number	:	845-227-6918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	08/10/2011

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