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General NPI Number Information
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NPI Number | 1306419130
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Entity Type | Individual
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Provider Name | CROY LAUGHLIN MS, LAC
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Gender | Male
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 100 TOWNSEND AVE
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City | BERLIN
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State | NJ
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Zip | 08009-9011
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Country | US
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Telephone | 800-433-7365
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MEMORIAL AVE APT 2
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City | PALMYRA
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State | NJ
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Zip | 08065-2550
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37AC0058
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License Number State | NJ
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