MEDICARE: AMY LAUREN MINELL

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	101YP2500X	Professional Counselor	37AC00925100	NJ

General Provider Information

NPI Number	:	1295685063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LAUREN MINELL

Provider Business Mailing Address
First Line	:	18 SCOTT CT APT C4
Second Line	:
City	:	RIDGEFIELD PARK
State	:	NJ
Zip	:	07660-1867
Country	:	US
Telephone Number	:	551-486-2488
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BETHANY RD STE 92
Second Line	:
City	:	HAZLET
State	:	NJ
Zip	:	07730-1669
Country	:	US
Telephone Number	:	855-500-3848
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ AMY LAUREN MINELL ” Practice Location

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