Provider Demographics
NPI:1164823647
Name:URGOLA, JOHN AUGUST (MA, LPC)
Entity Type:Individual
Prefix:PROF
First Name:JOHN
Middle Name:AUGUST
Last Name:URGOLA
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2113
Mailing Address - Country:US
Mailing Address - Phone:201-702-1551
Mailing Address - Fax:
Practice Address - Street 1:147 COLUMBIA TPKE
Practice Address - Street 2:SUITE 307
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2113
Practice Address - Country:US
Practice Address - Phone:201-702-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00503000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health