1861758104 NPI number — MS. LAURA L URCIUOLI MSW, LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861758104 NPI number — MS. LAURA L URCIUOLI MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URCIUOLI
Provider First Name:
LAURA
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICHARDSON
Provider Other First Name:
LAURA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861758104
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21-29 WAGNER PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07111-1861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-399-3132
Provider Business Mailing Address Fax Number:
973-399-7552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42 MEMORIAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARNEGAT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08005-1505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-891-8461
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC05591800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com