Provider Demographics
NPI:1518392299
Name:LAUREN, JAIME (DSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:LAUREN
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 WOODBINE CIR
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1737
Mailing Address - Country:US
Mailing Address - Phone:908-268-3702
Mailing Address - Fax:
Practice Address - Street 1:141 SOUTH AVE STE 7
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023
Practice Address - Country:US
Practice Address - Phone:908-268-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NJ44SC055368001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical