Provider Demographics
NPI:1891153110
Name:MCLAUREN, CAROLYN A (CCC-SLP;TSSLD)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:A
Last Name:MCLAUREN
Suffix:
Gender:F
Credentials:CCC-SLP;TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22343 MURDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2726
Mailing Address - Country:US
Mailing Address - Phone:917-921-2426
Mailing Address - Fax:
Practice Address - Street 1:325 BUSHWICK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-3404
Practice Address - Country:US
Practice Address - Phone:718-574-2318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist