Provider Demographics
NPI:1649418286
Name:LAURA JANIS HUBERMAN, LLC
Entity Type:Organization
Organization Name:LAURA JANIS HUBERMAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANIS
Authorized Official - Last Name:HUBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-926-8000
Mailing Address - Street 1:2106 NEW RD
Mailing Address - Street 2:SUITE E-1
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1046
Mailing Address - Country:US
Mailing Address - Phone:609-926-8000
Mailing Address - Fax:
Practice Address - Street 1:2106 NEW RD
Practice Address - Street 2:SUITE E-1
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1046
Practice Address - Country:US
Practice Address - Phone:609-926-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002870001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty