Active NPI
Laurel Wider, LCSW
- Mental Health Counselor
- New York, NY
National Provider Identifier
1164700407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 075901
- Practice address
- 138 West 25TH Street 6TH Floor Suite 3
New York, NY 10001 - Phone
- (646) 201-6983
- NPI assigned
- Aug 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 075901 | NY | Primary |
Addresses
Primary practice location
138 West 25TH Street 6TH Floor Suite 3
New York, NY 10001
Mailing address
138 West 25TH Street 6TH Floor Suite 3
New York, NY 10001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075901 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1164700407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 WEST 25TH STREET 6TH FLOOR SUITE 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 WEST 25TH STREET 6TH FLOOR SUITE 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10001",
"telephone_number": "646-201-6983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDER",
"first_name": "LAUREL",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-03",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "075901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.