Provider Demographics
NPI:1295490845
Name:REDDINGTON, LAUREN NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:REDDINGTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 ROCKAWAY RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4410
Mailing Address - Country:US
Mailing Address - Phone:732-485-4122
Mailing Address - Fax:
Practice Address - Street 1:195 SULLIVAN PL APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-2761
Practice Address - Country:US
Practice Address - Phone:732-585-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health