MEDICARE: BARBARA LAUER-LISTHAUS PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS006512-L	PA
2	103TC0700X	Clinical Psychologist	009703-1	NY
3	103TC0700X	Clinical Psychologist	35S100525200	NJ
4	103TC0700X	Clinical Psychologist	PSY9695	FL

General Provider Information

NPI Number	:	1720383524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA LAUER-LISTHAUS PSYD

Provider Business Mailing Address
First Line	:	66 W MOUNT PLEASANT AVE STE 205
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-2930
Country	:	US
Telephone Number	:	201-292-4233
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 W MOUNT PLEASANT AVE STE 205
Second Line	:
City	:	LIVINGSTON
State	:	NJ
Zip	:	07039-2930
Country	:	US
Telephone Number	:	201-292-4233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2011
Last Update Date	:	11/01/2019

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