Provider Demographics
NPI:1053433227
Name:STERN, LAURA ROSE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ROSE
Last Name:STERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:ROSE
Other - Last Name:SCHULZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 CLYDE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3425
Mailing Address - Country:US
Mailing Address - Phone:908-720-1776
Mailing Address - Fax:732-521-5113
Practice Address - Street 1:15 CLYDE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3425
Practice Address - Country:US
Practice Address - Phone:908-720-1776
Practice Address - Fax:732-521-5113
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051850001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical