Provider Demographics
NPI:1831207026
Name:BERMAN LEVY, AMANDA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:BERMAN LEVY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:BERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:85 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055
Mailing Address - Country:US
Mailing Address - Phone:973-916-1777
Mailing Address - Fax:
Practice Address - Street 1:349 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110
Practice Address - Country:US
Practice Address - Phone:973-517-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO14725001041C0700X
NYRO41346-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNYA251Medicare ID - Type Unspecified