Provider Demographics
NPI:1215372131
Name:PELLIZZI, LAUREN (LPC, LLC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PELLIZZI
Suffix:
Gender:F
Credentials:LPC, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 ROUTE 35 STE 5
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5918
Mailing Address - Country:US
Mailing Address - Phone:732-705-1882
Mailing Address - Fax:
Practice Address - Street 1:55 ROUTE 35 STE 5
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5918
Practice Address - Country:US
Practice Address - Phone:732-705-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00532600101YM0800X
NJ37AC00124800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health