Provider Demographics
NPI:1386148096
Name:BIRON, LAURE ELIZABETH (LSW, MSS)
Entity type:Individual
Prefix:MS
First Name:LAURE
Middle Name:ELIZABETH
Last Name:BIRON
Suffix:
Gender:F
Credentials:LSW, MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N CHANCELLOR ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2206
Mailing Address - Country:US
Mailing Address - Phone:215-630-1233
Mailing Address - Fax:
Practice Address - Street 1:1427 SPRUCE ST STE 8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4534
Practice Address - Country:US
Practice Address - Phone:215-584-8524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1300601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty