Provider Demographics
NPI:1063832038
Name:LURIE, STEVEN (PHD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LURIE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WOODSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-2238
Mailing Address - Country:US
Mailing Address - Phone:516-312-3428
Mailing Address - Fax:
Practice Address - Street 1:10 COBBLE CT
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3538
Practice Address - Country:US
Practice Address - Phone:516-312-3428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007034103TC0700X
CT3379103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical