Provider Demographics
NPI:1619546728
Name:AHMED, LAURA
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:111 DUNNELL RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2678
Mailing Address - Country:US
Mailing Address - Phone:908-967-7991
Mailing Address - Fax:
Practice Address - Street 1:111 DUNNELL RD STE 201
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2634
Practice Address - Country:US
Practice Address - Phone:917-846-9228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC060264001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical