MEDICARE: MS. LAUREN MCCORMACK LMSW

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	104100000X	Social Worker	121357	NY

General Provider Information

NPI Number	:	1205600749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN MCCORMACK LMSW

Provider Business Mailing Address
First Line	:	127 E 90TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-1567
Country	:	US
Telephone Number	:	516-860-0824
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 MCLEAN AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-4101
Country	:	US
Telephone Number	:	914-237-5121
Fax Number	:

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

Provider Enumeration Date	:	11/14/2023
Last Update Date	:	11/14/2023

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