Provider Demographics
NPI:1215685631
Name:VOLOTO, LARA DEMBERG (LMHC)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:DEMBERG
Last Name:VOLOTO
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 1:9 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-3103
Mailing Address - Country:US
Mailing Address - Phone:845-202-0713
Mailing Address - Fax:
Practice Address - Street 1:360 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3443
Practice Address - Country:US
Practice Address - Phone:914-588-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012237101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor