Individual provider Active NPI

Lauren Tetenbaum Dorman, LCSW, JD, PMH-C

  • Clinical Social Worker
  • Scarsdale, NY
National Provider Identifier
1114515301
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097477 Issued in NY
Practice address
14 Harwood CT Ste 512
Scarsdale, NY 10583-4120
Phone
(917) 301-0184
NPI assigned
Jan 4, 2021
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 097477 NY Primary

Addresses

Primary practice location

14 Harwood CT Ste 512
Scarsdale, NY 10583-4120

Mailing address

14 Innes Rd
Scarsdale, NY 10583-7110
Phone (917) 301-0184

Other names 1

  • Lauren A. Tetenbaum Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 3, 2024 through May 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
097477NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Tetenbaum Dorman LCSW PLLC Clinical CurrentSince Aug 4, 2024 Accepting new patients

Locations

14 Harwood Ct
Ste 512
Scarsdale, NY 10583
Phone (914) 721-0329

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1114515301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 INNES RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105837110",
            "telephone_number": "917-301-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HARWOOD CT STE 512",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834120",
            "telephone_number": "917-301-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "LAUREN",
        "middle_name": "TETENBAUM",
        "credential": "LCSW, JD, PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "TETENBAUM",
            "middle_name": "A.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.