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General NPI Number Information
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NPI Number | 1417542150
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Entity Type | Individual
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Provider Name | NICOLE LAMBERTI KAVANAGH MA, LAC, NCC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 25 LINDSLEY DR STE 203
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4456
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Country | US
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Telephone | 862-702-6238
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Fax |
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Provider Business Mailing Address
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Address Line | 8 TRACY LN
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-1508
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Country | US
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Telephone | 973-477-8051
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00529100
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License Number State | NJ
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