Provider Demographics
NPI:1992887988
Name:ZAMBRELLI, LAUREN M (LCSWR)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:M
Last Name:ZAMBRELLI
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 PEQUASH AVE
Mailing Address - Street 2:
Mailing Address - City:CUTCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11935-2284
Mailing Address - Country:US
Mailing Address - Phone:631-734-2802
Mailing Address - Fax:
Practice Address - Street 1:300 CENTER DR
Practice Address - Street 2:COUNTY CENTER BLDG-2ND
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-3393
Practice Address - Country:US
Practice Address - Phone:631-852-1440
Practice Address - Fax:631-852-1448
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-043757-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW3051Medicare ID - Type Unspecified