MEDICARE: MR. LAURENCE W. STUDER 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	LC6175	ME

General Provider Information

NPI Number	:	1205821105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAURENCE W. STUDER LCSW

Provider Business Mailing Address
First Line	:	PSC 47 BOX 584
Second Line	:
City	:	APO
State	:	AE
Zip	:	09470
Country	:	GB
Telephone Number	:	01480417131
Fax Number	:

Provider Business Practice Location Address
First Line	:	RAF UPWOOD
Second Line	:	UNIT 5610 BOX 223
City	:	APO
State	:	AE
Zip	:	09470-5610
Country	:	GB
Telephone Number	:	01487811039
Fax Number	:

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	07/21/2022

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