Provider Demographics
NPI:1184831026
Name:HENNION, LAUREN MICHELE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:MICHELE
Last Name:HENNION
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:MICHELE
Other - Last Name:PELLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:256 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1209
Mailing Address - Country:US
Mailing Address - Phone:973-765-9050
Mailing Address - Fax:973-765-0195
Practice Address - Street 1:256 COLUMBIA TURNPIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1209
Practice Address - Country:US
Practice Address - Phone:973-765-9050
Practice Address - Fax:973-765-9050
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05388000104100000X
NJ44SC053803001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ049832Medicaid