Provider Demographics
NPI:1962790790
Name:BROWN, LAURA JANE SCHMIDT (MA, LCSW, CASAC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JANE SCHMIDT
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LCSW, CASAC
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:J
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 TOTTEN AVE
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-1923
Mailing Address - Country:US
Mailing Address - Phone:631-586-0898
Mailing Address - Fax:
Practice Address - Street 1:21 PULASKI ROAD UNIT 242
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-1923
Practice Address - Country:US
Practice Address - Phone:631-260-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCASAC 24713101YA0400X
NYLMSW 078672104100000X
NY0870621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker