Provider Demographics
NPI:1255867214
Name:LONNAY, AMANDA (LPC, LCADC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LONNAY
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:DEFURIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1 BETHANY RD STE 69
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1668
Mailing Address - Country:US
Mailing Address - Phone:732-670-7723
Mailing Address - Fax:
Practice Address - Street 1:1 BETHANY RD STE 69
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1668
Practice Address - Country:US
Practice Address - Phone:732-670-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00314500101YA0400X
NJ37PC00583800101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health