Healthcare Provider Details

I. General information

NPI: 1386738904
Provider Name (Legal Business Name): LAURIE ENGEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 IKEA DR
WESTAMPTON NJ
08060
US

IV. Provider business mailing address

316 AUDUBON AVE 2ND FLOOR
AUDUBON NJ
08106
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-9339
  • Fax: 609-267-6655
Mailing address:
  • Phone: 609-267-9339
  • Fax: 609-267-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05252200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: