Provider Demographics
NPI:1326590571
Name:SIMICICH, LAUREN EMERSON (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:EMERSON
Last Name:SIMICICH
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ROUTE 526
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-2015
Mailing Address - Country:US
Mailing Address - Phone:732-512-8766
Mailing Address - Fax:
Practice Address - Street 1:112 ROUTE 526
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-2015
Practice Address - Country:US
Practice Address - Phone:609-807-8395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06042700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker