Provider Demographics
NPI:1740333020
Name:AUSTIN, LAVERNE E (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAVERNE
Middle Name:E
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 BAYARD ST P. O. BOX 691
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08903-0691
Mailing Address - Country:US
Mailing Address - Phone:732-917-0600
Mailing Address - Fax:888-528-2891
Practice Address - Street 1:1527 STATE ROUTE 27 STE 1600
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3905
Practice Address - Country:US
Practice Address - Phone:732-917-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC01382100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0043575Medicaid