Provider Demographics
NPI:1831213446
Name:MEYER, LAUREN PROCTON (PSYD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:PROCTON
Last Name:MEYER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2015
Mailing Address - Country:US
Mailing Address - Phone:973-783-3106
Mailing Address - Fax:973-783-3106
Practice Address - Street 1:6 POMPTON AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-2042
Practice Address - Country:US
Practice Address - Phone:973-783-4878
Practice Address - Fax:973-783-3106
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100389700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist