MEDICARE: MICHELLE LAJOIE 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	098742-1	NY

General Provider Information

NPI Number	:	1952817736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LAJOIE LMSW

Provider Business Mailing Address
First Line	:	1 ROCKET CT
Second Line	:
City	:	SELDEN
State	:	NY
Zip	:	11784-1828
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 HALLOCK RD STE 3A
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-3077
Country	:	US
Telephone Number	:	631-551-5095
Fax Number	:

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

Provider Enumeration Date	:	12/15/2017
Last Update Date	:	12/15/2017

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Directions to “ MICHELLE LAJOIE LMSW” Practice Location

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