Provider Demographics
NPI:1376133546
Name:MUNOZ-TORRES, LAURA PATRICIA (LPC, LAAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PATRICIA
Last Name:MUNOZ-TORRES
Suffix:
Gender:F
Credentials:LPC, LAAT, ATR-BC
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:PATRICIA
Other - Last Name:MUNOZ-TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, ATR-P
Mailing Address - Street 1:25 DODD ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1715
Mailing Address - Country:US
Mailing Address - Phone:201-564-8260
Mailing Address - Fax:
Practice Address - Street 1:155 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2311
Practice Address - Country:US
Practice Address - Phone:973-667-1884
Practice Address - Fax:973-667-2285
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37C00557600101YM0800X
NJ37PC00986800101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2311Medicaid