Provider Demographics
NPI:1831209907
Name:STAUB, LAURENA ANN (MA LPC NCC SAC CSP)
Entity type:Individual
Prefix:MRS
First Name:LAURENA
Middle Name:ANN
Last Name:STAUB
Suffix:
Gender:F
Credentials:MA LPC NCC SAC CSP
Other - Prefix:MISS
Other - First Name:LAURENA
Other - Middle Name:ANN
Other - Last Name:LONDREGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:220 COMMONS WAY
Mailing Address - Street 2:BLDG. B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6427
Mailing Address - Country:US
Mailing Address - Phone:732-341-8255
Mailing Address - Fax:732-237-9914
Practice Address - Street 1:220 COMMONS WAY
Practice Address - Street 2:BLDG. B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6427
Practice Address - Country:US
Practice Address - Phone:732-341-8255
Practice Address - Fax:732-237-9914
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC00364101Y00000X, 106H00000X
NJ585615103TS0200X
73473101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist