Provider Demographics
NPI:1790333524
Name:PRISCO, LAUREN M (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:PRISCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 SPIRAL DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2754
Mailing Address - Country:US
Mailing Address - Phone:848-333-8422
Mailing Address - Fax:
Practice Address - Street 1:35 BEAVERSON BLVD STE 11
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7869
Practice Address - Country:US
Practice Address - Phone:866-955-7866
Practice Address - Fax:030-573-2761
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00687900101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor