Provider Demographics
NPI:1831520451
Name:BENNA, LAUREN (LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BENNA
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 1:218 ROUTE 17 NORTH
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3399
Mailing Address - Country:US
Mailing Address - Phone:732-500-4431
Mailing Address - Fax:
Practice Address - Street 1:748 MORRIS TPKE
Practice Address - Street 2:SUITE 209
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2623
Practice Address - Country:US
Practice Address - Phone:862-259-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-07
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00432400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional