Healthcare Provider Details
I. General information
NPI: 1598550311
Provider Name (Legal Business Name): ALYSSA BARILARO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/11/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 S CHURCH ST STE 18
MOUNT LAUREL NJ
08054-2936
US
IV. Provider business mailing address
256 TAM OSHANTER RD
MOUNT LAUREL NJ
08054-2707
US
V. Phone/Fax
- Phone: 732-908-2696
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 37PC01192400 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: