Provider Demographics
NPI:1538503818
Name:CICCONE, LAUREN MARIE (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:CICCONE
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 1:625 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-4007
Mailing Address - Country:US
Mailing Address - Phone:732-344-0882
Mailing Address - Fax:
Practice Address - Street 1:625 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-4007
Practice Address - Country:US
Practice Address - Phone:732-344-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00544900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health