MEDICARE: ANGELA AMOIA, LICENSED MARRIAGE & FAMILY THERAPIST, CASAC, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	22569	NY
2	106H00000X	Marriage & Family Therapist	00726	NY

General Provider Information

NPI Number	:	1114159050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELA AMOIA, LICENSED MARRIAGE & FAMILY THERAPIST, CASAC, P.C.

Provider Business Mailing Address
First Line	:	11 MARSHALL RD STE 2P
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-4135
Country	:	US
Telephone Number	:	845-527-6723
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 MARSHALL RD STE 2P
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-4135
Country	:	US
Telephone Number	:	845-527-6723
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANGELA AMOIA
Credential	:	LMFT, CASAC
Telephone Number	:	845-527-6723

Provider Enumeration Date	:	08/11/2009
Last Update Date	:	08/11/2009

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