Provider Information for 1144983073
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LAUREN SCUPP LMHC, CRC
Sex: Female
NPI: 1144983073
Last Updated: 2023-04-27
Certification Date: 2022-01-04
Certification Date: 2022-01-04
Details
| Name | Value | ||||||||
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| NPI | 1144983073 | ||||||||
| Enumeration Date | 2021-10-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 19 ARROWHEAD DR SHIRLEY, NY 11967-2620 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 19 ARROWHEAD DR SHIRLEY, NY 11967-2620 United States Phone: 908-210-2408 | Fax: | ||||||||
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