=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851226500
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH CHRISTOPHER LAC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2026
-----------------------------------------------------
Last Update Date | 06/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 76 W JIMMIE LEEDS RD STE 305
-----------------------------------------------------
City | GALLOWAY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08205-9418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-916-6500
-----------------------------------------------------
Fax | 609-798-0112
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 76 W JIMMIE LEEDS RD STE 305
-----------------------------------------------------
City | GALLOWAY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08205-9418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-916-6500
-----------------------------------------------------
Fax | 609-798-0112
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 37AC00967500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------