Provider Demographics
NPI:1063593697
Name:LANIER, ELIZABETH LORRAINE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LORRAINE
Last Name:LANIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 71ST ROAD
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4972
Mailing Address - Country:US
Mailing Address - Phone:718-520-0109
Mailing Address - Fax:
Practice Address - Street 1:11050 71ST ROAD
Practice Address - Street 2:SUITE 1E
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4972
Practice Address - Country:US
Practice Address - Phone:718-520-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0004951041C0700X
NY000196106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist