MEDICARE: MRS. AMANDA L WESTRICH MA, LCADC

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	37LC00306200	NJ

General Provider Information

NPI Number	:	1093305245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA L WESTRICH MA, LCADC

Provider Business Mailing Address
First Line	:	21 S WESTFIELD RD
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-2323
Country	:	US
Telephone Number	:	973-390-0285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1999 ROUTE 88
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3152
Country	:	US
Telephone Number	:	732-814-3005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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