Provider Demographics
NPI:1649782236
Name:TARIKYAN, LAURA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TARIKYAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 ENGLE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2905
Mailing Address - Country:US
Mailing Address - Phone:201-227-2562
Mailing Address - Fax:201-227-2571
Practice Address - Street 1:44 ENGLE ST FL 2
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2905
Practice Address - Country:US
Practice Address - Phone:201-227-2562
Practice Address - Fax:201-227-2571
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NJ44SC057473001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical