MEDICARE: ALEXANDRA WAIDELICH LPC

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	37PC01109700	NJ

General Provider Information

NPI Number	:	1699580761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA WAIDELICH LPC

Provider Business Mailing Address
First Line	:	20 BRIER RD
Second Line	:
City	:	WHITEHOUSE STATION
State	:	NJ
Zip	:	08889-3045
Country	:	US
Telephone Number	:	201-870-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 BRIER RD
Second Line	:
City	:	WHITEHOUSE STATION
State	:	NJ
Zip	:	08889-3045
Country	:	US
Telephone Number	:	201-870-1616
Fax Number	:

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

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	12/08/2025

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Directions to “ ALEXANDRA WAIDELICH LPC” Practice Location

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