Provider Demographics
NPI:1093485476
Name:LLORET, MARISA K (LPC)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:K
Last Name:LLORET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 NOVACK DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08312-2128
Mailing Address - Country:US
Mailing Address - Phone:856-398-0152
Mailing Address - Fax:
Practice Address - Street 1:280 NOVACK DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08312-2128
Practice Address - Country:US
Practice Address - Phone:856-398-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ275197279OtherLPC