Provider Demographics
NPI:1528526605
Name:LACHERZA-DREW, NICOLE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MARIE
Last Name:LACHERZA-DREW
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:LACHERZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:518 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-2616
Mailing Address - Country:US
Mailing Address - Phone:201-639-4046
Mailing Address - Fax:
Practice Address - Street 1:518 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852-2616
Practice Address - Country:US
Practice Address - Phone:201-639-4046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4504103TC1900X
VT048.0134265103TC1900X
NY023117103TC1900X
FL544103TC1900X
NJ35SI00610200103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling