Provider Demographics
NPI:1962180885
Name:LUCARIELLO, SANDRA (MA, EDS, LPC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:LUCARIELLO
Suffix:
Gender:F
Credentials:MA, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2725
Mailing Address - Country:US
Mailing Address - Phone:732-329-4044
Mailing Address - Fax:
Practice Address - Street 1:294 SHELBURNE PL
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-2107
Practice Address - Country:US
Practice Address - Phone:732-221-6276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00338800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health