Provider Demographics
NPI:1881240562
Name:WINTERS, ANDREA M (LPC, LMHC, CCMHC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LPC, LMHC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 KNAPP TER
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1216
Mailing Address - Country:US
Mailing Address - Phone:201-394-9789
Mailing Address - Fax:
Practice Address - Street 1:125 KNAPP TER
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1216
Practice Address - Country:US
Practice Address - Phone:201-394-9789
Practice Address - Fax:201-947-2563
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC000413000101YP2500X
NJ37PC0041300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional