Provider Demographics
NPI:1669862389
Name:GUANCIONE, LAURA A (MA, LPC, LCADC, ACS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:GUANCIONE
Suffix:
Gender:F
Credentials:MA, LPC, LCADC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 136
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874
Mailing Address - Country:US
Mailing Address - Phone:973-664-7154
Mailing Address - Fax:
Practice Address - Street 1:18 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-0786
Practice Address - Country:US
Practice Address - Phone:973-664-7154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00433600101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health