Provider Demographics
NPI:1518492925
Name:LOTANO, LINDA PILGRIM (MS, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:PILGRIM
Last Name:LOTANO
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MAPLE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1715
Mailing Address - Country:US
Mailing Address - Phone:732-523-4345
Mailing Address - Fax:
Practice Address - Street 1:103 MAPLE AVE STE 202
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1715
Practice Address - Country:US
Practice Address - Phone:732-523-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-23
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00336600106H00000X
NJ37PC00755100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist