Provider Demographics
NPI:1518085778
Name:PORCARO, LAURA THERESA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:THERESA
Last Name:PORCARO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2002
Mailing Address - Country:US
Mailing Address - Phone:201-848-5487
Mailing Address - Fax:201-848-1911
Practice Address - Street 1:24 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1927
Practice Address - Country:US
Practice Address - Phone:201-848-5487
Practice Address - Fax:201-848-1911
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053125001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical