Provider Demographics
NPI:1720580954
Name:ALFARO, LAUREN (MA, EDS, LPC)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:ALFARO
Suffix:
Gender:F
Credentials:MA, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2130
Mailing Address - Country:US
Mailing Address - Phone:973-930-4600
Mailing Address - Fax:
Practice Address - Street 1:174 RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2130
Practice Address - Country:US
Practice Address - Phone:973-930-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-04
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00941900101YP2500X
NJ37AC00400800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselor