Provider Demographics
NPI:1982784419
Name:SUCHER, LAURA ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELLEN
Last Name:SUCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 784
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-0784
Mailing Address - Country:US
Mailing Address - Phone:732-264-2440
Mailing Address - Fax:732-698-0504
Practice Address - Street 1:3 AUER CT
Practice Address - Street 2:SUITE F
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5825
Practice Address - Country:US
Practice Address - Phone:732-264-2440
Practice Address - Fax:732-698-0504
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000882001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical