Provider Demographics
NPI:1891901195
Name:PISERCHIA, LAUREN (MSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PISERCHIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 HIGHWAY 34
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MATAWAN
Mailing Address - State:NM
Mailing Address - Zip Code:07747-6680
Mailing Address - Country:US
Mailing Address - Phone:732-264-8878
Mailing Address - Fax:732-566-7727
Practice Address - Street 1:746 STATE ROUTE 34
Practice Address - Street 2:SUITE 3
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-6685
Practice Address - Country:US
Practice Address - Phone:732-264-8878
Practice Address - Fax:732-566-7747
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00104100101YA0400X
NJ44SC006731001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical