Provider Demographics
NPI:1992996805
Name:TRAVAGLINI, LAURA ANN (MA)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:TRAVAGLINI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 E 60TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1096
Mailing Address - Country:US
Mailing Address - Phone:212-326-8441
Mailing Address - Fax:212-326-8590
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1096
Practice Address - Country:US
Practice Address - Phone:212-326-8441
Practice Address - Fax:212-326-8590
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-004550101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health