Healthcare Provider Details

I. General information

NPI: 1689933574
Provider Name (Legal Business Name): LAUREN MICHELLE PARKE MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4326 US HIGHWAY 1
MONMOUTH JUNCTION NJ
08852-1906
US

IV. Provider business mailing address

4326 US HIGHWAY 1
MONMOUTH JUNCTION NJ
08852-1906
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-5910
  • Fax: 609-514-0420
Mailing address:
  • Phone: 732-235-5910
  • Fax: 609-514-0420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: