Healthcare Provider Details

I. General information

NPI: 1609844786
Provider Name (Legal Business Name): GERALD A. OPTHOF LPC, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 3RD AVE SUITE 1-B
WESTWOOD NJ
07675-2154
US

IV. Provider business mailing address

16 OVERLOOK AVE
EMERSON NJ
07630-1018
US

V. Phone/Fax

Practice location:
  • Phone: 201-457-7457
  • Fax: 201-576-0166
Mailing address:
  • Phone: 201-576-0075
  • Fax: 201-576-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC2845
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37PC00070400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: