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Individual

AMANDA WALSTEDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LCADC

Contact information

Practice address
80 MAIN ST STE 500, WEST ORANGE, NJ 07052-5414
(973) 964-5769
Mailing address
97 BLEECKER ST APT 11, JERSEY CITY, NJ 07307-3400

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00381100
NJ
101YP2500X
Professional Counselor
Primary
37PC00987400
NJ

Other

Enumeration date
11/01/2024
Last updated
11/01/2024
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