Provider Demographics
NPI:1104248103
Name:MAGRO, LAURENCE MARIE (LMHC)
Entity type:Individual
Prefix:MS
First Name:LAURENCE
Middle Name:MARIE
Last Name:MAGRO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BONNIE BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1347
Mailing Address - Country:US
Mailing Address - Phone:914-833-1675
Mailing Address - Fax:914-834-2234
Practice Address - Street 1:14 BONNIE BRIAR LN
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-1347
Practice Address - Country:US
Practice Address - Phone:914-833-1675
Practice Address - Fax:914-834-2234
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004226101YM0800X
CT001638101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional