MEDICARE: ASHLEY URENA LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	37AC00804500	NJ

General Provider Information

NPI Number	:	1578392304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY URENA LAC

Provider Business Mailing Address
First Line	:	124 DONNA DR
Second Line	:
City	:	BURLINGTON TOWNSHIP
State	:	NJ
Zip	:	08016-2021
Country	:	US
Telephone Number	:	201-283-6723
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 CLARKSVILLE RD STE 4A
Second Line	:
City	:	PRINCETON JUNCTION
State	:	NJ
Zip	:	08550-5300
Country	:	US
Telephone Number	:	732-982-2888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	02/04/2026

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