Provider Demographics
NPI:1184244550
Name:FALLAT, LAUREN GIOVANNA (LPC, LPAT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:GIOVANNA
Last Name:FALLAT
Suffix:
Gender:F
Credentials:LPC, LPAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NEW AMWELL RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5516
Mailing Address - Country:US
Mailing Address - Phone:908-857-4422
Mailing Address - Fax:
Practice Address - Street 1:101 NEW AMWELL RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5516
Practice Address - Country:US
Practice Address - Phone:908-857-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-25
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17-525221700000X
NJ37PC00697500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist