Provider Demographics
NPI:1457676454
Name:LAUER, NADINE (LPC)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:LAUER
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 1:685 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1630
Mailing Address - Country:US
Mailing Address - Phone:973-239-0948
Mailing Address - Fax:973-239-0972
Practice Address - Street 1:685 BLOOMFIELD AVE,
Practice Address - Street 2:SUITE 201
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044
Practice Address - Country:US
Practice Address - Phone:973-239-0948
Practice Address - Fax:973-239-0972
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00212400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist