Provider Demographics
NPI:1720420789
Name:LAZZARO, DANIELLE L (LPC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:LAZZARO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W MAIN ST
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2146
Mailing Address - Country:US
Mailing Address - Phone:732-533-3933
Mailing Address - Fax:
Practice Address - Street 1:57 W MAIN ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2146
Practice Address - Country:US
Practice Address - Phone:732-533-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00474000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional