Provider Demographics
NPI:1982974366
Name:LAURICELLA, JENNIFER ANN (BA)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ANN
Last Name:LAURICELLA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NEPTUNE DR N
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2126
Mailing Address - Country:US
Mailing Address - Phone:856-582-3900
Mailing Address - Fax:
Practice Address - Street 1:1 NEPTUNE DR N
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2126
Practice Address - Country:US
Practice Address - Phone:856-582-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health