Provider Demographics
NPI:1366038721
Name:BITTERMAN, AMANDA (MA, LPC, LAC, NCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BITTERMAN
Suffix:
Gender:F
Credentials:MA, LPC, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CEZAR CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5917
Mailing Address - Country:US
Mailing Address - Phone:973-219-5432
Mailing Address - Fax:
Practice Address - Street 1:12 CEZAR CT
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5917
Practice Address - Country:US
Practice Address - Phone:973-219-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00913200101YP2500X
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health