Provider Demographics
NPI:1841350766
Name:FLORENTINO, MARIE CLAIRE (LPC, LCADC)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:CLAIRE
Last Name:FLORENTINO
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900C LAKE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1281
Mailing Address - Country:US
Mailing Address - Phone:973-460-6463
Mailing Address - Fax:201-818-8968
Practice Address - Street 1:900C LAKE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1281
Practice Address - Country:US
Practice Address - Phone:973-460-6463
Practice Address - Fax:201-818-8968
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00107800101YA0400X
NJ37PC00337500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)