Individual
AVERY NICOLE ITALIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMFT, LCADC
Contact information
Practice address
232 AZALEA CT, TOMS RIVER, NJ 08753-1330
(610) 216-7195
Mailing address
232 AZALEA CT, TOMS RIVER, NJ 08753-1330
(610) 216-7195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00297200
NJ
101YM0800X
Mental Health Counselor
Primary
37F100189800
NJ
Other
Enumeration date
05/20/2019
Last updated
09/03/2024
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