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NPI Code Detail

MEDICARE: AMANDA L ELLER MS, LSW, C-SSW

MEDICARE: AMANDA L ELLER MS, LSW, C-SSW
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
1101YM0800XMental Health Counselor44SL06221500NJ

General Provider Information

NPI Number : 1821531195
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA L ELLER MS, LSW, C-SSW
Provider Business Mailing Address
First Line : 1127 ROUTE 47 S STE 9
Second Line :
City : RIO GRANDE
State : NJ
Zip : 08242-1609
Country : US
Telephone Number : 609-486-2003
Fax Number :
Provider Business Practice Location Address
First Line : 1127 ROUTE 47 S STE 9
Second Line :
City : RIO GRANDE
State : NJ
Zip : 08242-1609
Country : US
Telephone Number : 609-468-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2016
Last Update Date : 08/24/2023

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