Provider Demographics
NPI:1639560360
Name:LOMBARDO, VIVIAN (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JENNINGS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3307
Mailing Address - Country:US
Mailing Address - Phone:609-512-5483
Mailing Address - Fax:
Practice Address - Street 1:21 JENNINGS RD STE 1
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3307
Practice Address - Country:US
Practice Address - Phone:609-512-5483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00564800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional