Provider Demographics
NPI:1679165922
Name:ADJAH, LAWRENCE EKWANG
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:EKWANG
Last Name:ADJAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 LAFAYETTE ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-4615
Mailing Address - Country:US
Mailing Address - Phone:347-712-1394
Mailing Address - Fax:
Practice Address - Street 1:170 LAFAYETTE ST APT 4C
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-4615
Practice Address - Country:US
Practice Address - Phone:347-712-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YP1600X
NJ101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral