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NPI Code Detail

MEDICARE: MISS MADELEINE GRACE LORENZEN LMSW

MEDICARE: MISS MADELEINE GRACE LORENZEN 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
11041C0700XClinical Social Worker122851NY

General Provider Information

NPI Number : 1922854348
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MADELEINE GRACE LORENZEN LMSW
Provider Business Mailing Address
First Line : 1419 MERMAID AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11224-2615
Country : US
Telephone Number : 718-210-3110
Fax Number : 718-333-0865
Provider Business Practice Location Address
First Line : 1419 MERMAID AVE
Second Line : GROUND LEVEL
City : BROOKLYN
State : NY
Zip : 11224-2615
Country : US
Telephone Number : 718-210-3110
Fax Number : 718-333-0865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2024
Last Update Date : 04/26/2024

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Directions to “ MISS MADELEINE GRACE LORENZEN LMSW” Practice Location

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