Provider Demographics
NPI:1740825850
Name:ZAVATTIERI, AMANDA AUDREY (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:AUDREY
Last Name:ZAVATTIERI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:AUDREY
Other - Last Name:FAULHABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:1 MAIN ST STE 314
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3905
Mailing Address - Country:US
Mailing Address - Phone:800-605-0612
Mailing Address - Fax:800-605-0612
Practice Address - Street 1:1 MAIN ST STE 314
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3905
Practice Address - Country:US
Practice Address - Phone:800-605-0612
Practice Address - Fax:800-605-0612
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00605300101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor