Provider Demographics
NPI:1285935569
Name:MICHEL, LAURA (MSW, LSW, LCADC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:MSW, LSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WHISPER WAY E
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-2125
Mailing Address - Country:US
Mailing Address - Phone:973-713-9484
Mailing Address - Fax:
Practice Address - Street 1:56 MOUNT KEMBLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-540-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00230500101YA0400X
NJ44SL05796500104100000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4138601Medicaid
NJ4138601Medicaid