Provider Demographics
NPI:1487877932
Name:LAGARELLA, LYNN M (BS CPRP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:M
Last Name:LAGARELLA
Suffix:
Gender:F
Credentials:BS CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BLACKHAWK COURT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055
Mailing Address - Country:US
Mailing Address - Phone:609-714-0879
Mailing Address - Fax:
Practice Address - Street 1:383 W STATE STREET
Practice Address - Street 2:CATHOLIC CHARITIES
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618
Practice Address - Country:US
Practice Address - Phone:609-394-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health