Provider Demographics
NPI:1356881791
Name:MORRISON, LAUREN STANTON
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:STANTON
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 NEWTON AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OAKLYN
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1446
Mailing Address - Country:US
Mailing Address - Phone:609-458-1154
Mailing Address - Fax:
Practice Address - Street 1:304 NEWTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:OAKLYN
Practice Address - State:NJ
Practice Address - Zip Code:08107-1446
Practice Address - Country:US
Practice Address - Phone:609-458-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00577900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional