Provider Demographics
NPI:1154525384
Name:HALLSTEIN, LANA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LANA
Middle Name:
Last Name:HALLSTEIN
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 1:365 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6511
Mailing Address - Country:US
Mailing Address - Phone:212-496-6680
Mailing Address - Fax:212-979-8807
Practice Address - Street 1:365 W END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6511
Practice Address - Country:US
Practice Address - Phone:212-496-6680
Practice Address - Fax:212-979-8807
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044762-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical