Lauren Culkin, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · West Milford, NJ

NPI 1376010298 · NPPES record last updated Mar 4, 2019

Key facts

NPI
1376010298
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
41YS00821500 (NJ)
Practice address
107 Broadway
West Milford, NJ 07480-4319
Phone
(484) 467-6614
NPI assigned
Oct 29, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
41YS00821500NJMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193400000X SINGLE SPECIALTY GROUP
235Z00000X 41YS00821500 NJ Yes

Addresses

Primary practice location

107 Broadway
West Milford, NJ 07480-4319

Mailing address

107 Broadway
West Milford, NJ 07480-4319
Phone (484) 467-6614

Other names

  • Lauren Rustad Former name

Other providers in West Milford, NJ

All providers in West Milford, NJ · Speech-Language Pathologist in New Jersey

Sources for this page

Verify at the official NPI Registry.