Provider Demographics
NPI:1396905220
Name:MERREN, EUGENE M (LPC)
Entity type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:M
Last Name:MERREN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5604
Mailing Address - Country:US
Mailing Address - Phone:862-881-4099
Mailing Address - Fax:
Practice Address - Street 1:59 GLEN AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2634
Practice Address - Country:US
Practice Address - Phone:973-256-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00094500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional