Provider Demographics
NPI:1619416211
Name:HOGE, LAURA HIGGINS (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HIGGINS
Last Name:HOGE
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622-624 VALLEY ROAD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043
Mailing Address - Country:US
Mailing Address - Phone:908-642-5061
Mailing Address - Fax:
Practice Address - Street 1:622-624 VALLEY ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-0704
Practice Address - Country:US
Practice Address - Phone:908-642-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO57212001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical