Provider Demographics
NPI:1063626562
Name:LAWRENCE, JENNIFER LORRAINE (LPC, LPAT, ATR-BC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LORRAINE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LPC, LPAT, ATR-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LORRAINE
Other - Last Name:TRINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:720-771-6933
Mailing Address - Fax:
Practice Address - Street 1:150 GLENDALE DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:720-771-6933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37P00570400101YP2500X
CO221700000X
NJ16LP00003800221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional