Provider Demographics
NPI:1720815962
Name:ALBERTSON, LORIEN (MHC)
Entity type:Individual
Prefix:
First Name:LORIEN
Middle Name:
Last Name:ALBERTSON
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:PORTER CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12859-1917
Mailing Address - Country:US
Mailing Address - Phone:518-636-9856
Mailing Address - Fax:
Practice Address - Street 1:196 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1230
Practice Address - Country:US
Practice Address - Phone:518-439-0033
Practice Address - Fax:518-439-7167
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty