| Stacey Blauth, Lpc Lcadc | |
|
500 Main St Bldg 2 Lanoka Harbor NJ 08734-2228 | |
| (609) 971-8989 | |
| (609) 242-3207 |
| Full Name | Stacey Blauth, Lpc Lcadc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 500 Main St Bldg 2, Lanoka Harbor, New Jersey |
| Authorized Official Name and Position | Patricia Blanchettte (OFFICE MANAGER) |
| Authorized Official Contact | 6099718989 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey Blauth, Lpc Lcadc 1131 Laurel Blvd Lanoka Harbor NJ 08734-2903 Ph: (609) 971-8989 | Stacey Blauth, Lpc Lcadc 500 Main St Bldg 2 Lanoka Harbor NJ 08734-2228 Ph: (609) 971-8989 |
| NPI Number | 1871843813 |
|---|---|
| Provider Enumeration Date | 09/18/2012 |
| Last Update Date | 09/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871843813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 37PC00350900 (New Jersey) | Primary |
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