Provider Demographics
NPI:1689321135
Name:CINTRON, LAILA (LAC)
Entity Type:Individual
Prefix:MS
First Name:LAILA
Middle Name:
Last Name:CINTRON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 BROAD ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2884
Mailing Address - Country:US
Mailing Address - Phone:862-930-5700
Mailing Address - Fax:
Practice Address - Street 1:1018 BROAD ST STE 6
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2884
Practice Address - Country:US
Practice Address - Phone:862-930-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00570000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health