Provider Demographics
NPI:1669537320
Name:O'LEARY, LORI (MA, LPC, LCADC)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:MA, LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 CLEMENTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1814
Mailing Address - Country:US
Mailing Address - Phone:856-547-1107
Mailing Address - Fax:856-547-1130
Practice Address - Street 1:630 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1814
Practice Address - Country:US
Practice Address - Phone:856-547-1107
Practice Address - Fax:856-547-1130
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00282100101YM0800X
PAPC002352101YM0800X
101YP2500X
NJ37LC00070300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ534834000OtherMAGELLAN ID
NJ2105655000OtherBLUE CROSS BLUE SHIELD ID