Provider Demographics
NPI:1487845012
Name:BERARDI, AMANDA J (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:BERARDI
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 CHERRY BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4207
Mailing Address - Country:US
Mailing Address - Phone:609-214-2115
Mailing Address - Fax:
Practice Address - Street 1:480 KING AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1430
Practice Address - Country:US
Practice Address - Phone:856-240-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00553000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist