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General NPI Number Information
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NPI Number | 1881240562
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Entity Type | Individual
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Provider Name | ANDREA M. WINTERS LPC, LMHC, CCMHC
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Gender | Female
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Dates
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Enumeration Date | 08/17/2019
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Last Update Date | 08/17/2019
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Provider Practice Location Address
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Address Line | 125 KNAPP TER
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City | LEONIA
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State | NJ
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Zip | 07605-1216
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Country | US
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Telephone | 201-394-9789
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Fax | 201-947-2563
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Provider Business Mailing Address
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Address Line | 125 KNAPP TER
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City | LEONIA
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State | NJ
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Zip | 07605-1216
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Country | US
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Telephone | 201-394-9789
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC000413000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC0041300
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License Number State | NJ
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