Provider Demographics
NPI:1053729780
Name:LAURIE ENGEL LLC
Entity type:Organization
Organization Name:LAURIE ENGEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-320-2821
Mailing Address - Street 1:212 W ROUTE 38
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3238
Mailing Address - Country:US
Mailing Address - Phone:856-320-2821
Mailing Address - Fax:856-210-7272
Practice Address - Street 1:212 W ROUTE 38
Practice Address - Street 2:SUITE 200
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3238
Practice Address - Country:US
Practice Address - Phone:856-320-2821
Practice Address - Fax:856-210-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052522001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty