Healthcare Provider Details

I. General information

NPI: 1205577012
Provider Name (Legal Business Name): AMANDA STARCEV LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 STATE RT 17 STE 6 #3048
MAHWAH NJ
07430
US

IV. Provider business mailing address

479 STATE RT 17 STE 6
MAHWAH NJ
07430-2116
US

V. Phone/Fax

Practice location:
  • Phone: 201-983-3420
  • Fax:
Mailing address:
  • Phone: 201-983-3420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06410900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: