Provider Demographics
NPI:1821653973
Name:VAIRO, JACLYN LAUREN (LPC)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:LAUREN
Last Name:VAIRO
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 1:6 BRYN MAWR RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3608
Mailing Address - Country:US
Mailing Address - Phone:201-532-6314
Mailing Address - Fax:
Practice Address - Street 1:12 TROY HILLS RD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1538
Practice Address - Country:US
Practice Address - Phone:973-304-5661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00672700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty