Provider Demographics
NPI:1508996661
Name:DUTTON, LAURIE ANN (MA, LPC, LCADC)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ANN
Last Name:DUTTON
Suffix:
Gender:F
Credentials:MA, LPC, LCADC
Other - Prefix:MRS
Other - First Name:LAURIE
Other - Middle Name:DUTTON
Other - Last Name:MARKON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LAC
Mailing Address - Street 1:501 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-2230
Mailing Address - Country:US
Mailing Address - Phone:571-437-7265
Mailing Address - Fax:
Practice Address - Street 1:1601 ATLANTIC AVE
Practice Address - Street 2:1ST FLOOR, ADULT INTERVENTION SERVICES
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6928
Practice Address - Country:US
Practice Address - Phone:609-572-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00377700101YP2500X
NJ37LC00154600101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)