Healthcare Provider Details

I. General information

NPI: 1881587897
Provider Name (Legal Business Name): LORI BETH INFELD MA, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 OLD MARLTON PIKE STE 101
MEDFORD NJ
08055-8772
US

IV. Provider business mailing address

PO BOX 121
WESTVILLE NJ
08093-0121
US

V. Phone/Fax

Practice location:
  • Phone: 856-223-2222
  • Fax:
Mailing address:
  • Phone: 410-980-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00732500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: