Individual provider Active NPI

Lauren Marie Lang, LCSW

  • Clinical Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1104499789
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092266 Issued in NY
Practice address
215 Titusville Rd
Poughkeepsie, NY 12603-3241
Phone
(845) 625-3524
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 095554 NY
Clinical Social Worker 1041C0700X 092266 NY Primary

Addresses

Primary practice location

215 Titusville Rd
Poughkeepsie, NY 12603-3241

Mailing address

1607 Route 300 Ste 101
Newburgh, NY 12550-1738
Phone (845) 567-6027

Other names 1

  • Lauren Marie Fanelli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219001716 NY Practitioner - Clinical Social Worker 8123555851 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
095554NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services CurrentSince Jul 25, 2021 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Dec 17, 2024 Accepting new patients
Che Senior Psychological Services, PC Clinical CurrentSince Dec 17, 2024 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384

1607 Route 300
Ste 101
Newburgh, NY 12550
Phone (845) 567-6027

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1104499789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 ROUTE 300 STE 101",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501738",
            "telephone_number": "845-567-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TITUSVILLE RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033241",
            "telephone_number": "845-625-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "095554",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "FANELLI",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.