Provider Demographics
NPI:1699801191
Name:LEINWAND, LAURIE R (MA LPC)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:R
Last Name:LEINWAND
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ARNOLD DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-3338
Mailing Address - Country:US
Mailing Address - Phone:973-537-1818
Mailing Address - Fax:973-537-1818
Practice Address - Street 1:715 ROUTE 10 E
Practice Address - Street 2:SUITE 207
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2025
Practice Address - Country:US
Practice Address - Phone:973-306-9996
Practice Address - Fax:973-537-1818
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00352200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional