Individual
MRS. LAUREN BROOKE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
537 N BROAD ST, WOODBURY, NJ 08096-1603
(856) 686-5500
Mailing address
235 SYRACUSE AVE, WENONAH, NJ 08090-1049
(267) 265-6357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00271900
NJ
101YP2500X
Professional Counselor
Primary
37AC00467900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00271900
LCADC
NJ
Enumeration date
07/04/2018
Last updated
07/18/2022
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