Provider Demographics
NPI:1447547179
Name:JURGENS, MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:JURGENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2137 ROUTE 33
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1740
Mailing Address - Country:US
Mailing Address - Phone:609-731-7610
Mailing Address - Fax:
Practice Address - Street 1:2137 ROUTE 33
Practice Address - Street 2:SUITE 3
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1740
Practice Address - Country:US
Practice Address - Phone:609-731-7610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00384200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health