Provider Demographics
NPI:1639215999
Name:STEIN, LAWRENCE BRETT (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BRETT
Last Name:STEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2154
Mailing Address - Country:US
Mailing Address - Phone:732-747-8818
Mailing Address - Fax:732-747-8918
Practice Address - Street 1:316 BROAD ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2154
Practice Address - Country:US
Practice Address - Phone:732-747-8818
Practice Address - Fax:732-747-8918
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ3970103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist