Provider Demographics
NPI:1316655350
Name:LUGO QUINONES, DANIELLE (LAC, NCC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LUGO QUINONES
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 BRICK BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6080
Mailing Address - Country:US
Mailing Address - Phone:732-397-2082
Mailing Address - Fax:
Practice Address - Street 1:445 BRICK BLVD STE 304
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6080
Practice Address - Country:US
Practice Address - Phone:732-814-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00677900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health