MEDICARE: LAURIE CIAVARDINI 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	104100000X	Social Worker	0496761	NY

General Provider Information

NPI Number	:	1841278819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE CIAVARDINI LCSW

Provider Business Mailing Address
First Line	:	PO BOX 16
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-0016
Country	:	US
Telephone Number	:	914-672-6694
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 COURT ROAD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506
Country	:	US
Telephone Number	:	914-205-3349
Fax Number	:

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	11/18/2020

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