Provider Demographics
NPI:1053515510
Name:CARLSON-HEALY, LORIN (RN, LCSW)
Entity type:Individual
Prefix:
First Name:LORIN
Middle Name:
Last Name:CARLSON-HEALY
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:
Other - First Name:LORIN
Other - Middle Name:
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 E KING ST APT 224
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2543
Mailing Address - Country:US
Mailing Address - Phone:914-467-0866
Mailing Address - Fax:
Practice Address - Street 1:233 E KING ST APT 224
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2543
Practice Address - Country:US
Practice Address - Phone:914-467-0866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN637123163WC0400X
NYR0363881041C0700X
PACW0207701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGS467OtherOXFORD UHC
NYGS467OtherOXFORD HEALTH PLAN