Provider Demographics
NPI:1982571543
Name:CARNEVALE, LAUREN JOY
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JOY
Last Name:CARNEVALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1130
Mailing Address - Country:US
Mailing Address - Phone:732-690-0922
Mailing Address - Fax:
Practice Address - Street 1:95 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1130
Practice Address - Country:US
Practice Address - Phone:732-690-0922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71807103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool