Provider Demographics
NPI:1043789563
Name:SCRIPKO, LAURYN ELAINE (LSW)
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:ELAINE
Last Name:SCRIPKO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BERGEN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-5501
Mailing Address - Country:US
Mailing Address - Phone:732-299-2164
Mailing Address - Fax:
Practice Address - Street 1:26 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-5501
Practice Address - Country:US
Practice Address - Phone:732-299-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06307800104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker