Carly Lawrence

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

009846 Issued in NY

Practice address

130 Montauk Hwy Unit F
East Moriches, NY 11940-1153

Phone

(631) 874-0571

NPI assigned

Aug 21, 2018

Last updated

Jun 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1265912927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PETERS DR",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674215",
            "telephone_number": "631-300-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MONTAUK HWY UNIT F",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401153",
            "telephone_number": "631-874-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "009846",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "405927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY ASSISTANT LICENSE NUMBER",
            "identifier": "009846",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca A Kincade, IDHS
• Jennifer Lynn Klingenberger-Beyer, M.D.
• Lisa Kominos
• Stacy Ann Krey, LMT
• Melanie Kuklis, N/A
• Irene Logan, NURSE PRACTITIONER
• Diana Lucenti
• Kristina Macdonald, CRC
• Erica Lee Mailand, MA
• Kathleen Frances Malsky, LCSW

• Occupational Therapy Assistant in East Moriches, NY
• Providers in East Moriches, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.