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NPI Code Detail

MEDICARE: MS. LAUREN KIMBERLY PEARL LCSW

MEDICARE: MS. LAUREN KIMBERLY PEARL LCSW
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
11041C0700XClinical Social Worker44SC05357800NJ

General Provider Information

NPI Number : 1770731408
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN KIMBERLY PEARL LCSW
Provider Business Mailing Address
First Line : 6600 KENNEDY BLVD E
Second Line : APT 1N
City : WEST NEW YORK
State : NJ
Zip : 07093-4232
Country : US
Telephone Number : 201-306-2968
Fax Number :
Provider Business Practice Location Address
First Line : 1 PLAZA LN
Second Line :
City : RAMSEY
State : NJ
Zip : 07446-1829
Country : US
Telephone Number : 201-306-2968
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2008
Last Update Date : 09/06/2008

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