Provider Demographics
NPI:1609844786
Name:OPTHOF, GERALD A (LPC, LCADC)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:A
Last Name:OPTHOF
Suffix:
Gender:M
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1018
Mailing Address - Country:US
Mailing Address - Phone:201-576-0075
Mailing Address - Fax:201-576-0166
Practice Address - Street 1:192 3RD AVE
Practice Address - Street 2:SUITE 1-B
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2154
Practice Address - Country:US
Practice Address - Phone:201-457-7457
Practice Address - Fax:201-576-0166
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC2845101Y00000X
NJ37PC00070400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)