IndividualActive
Amelo Bacchus, LAC
NPI 1205656402 · Mental Health Counselor · East Orange, NJ
Provider details
- NPI number
- 1205656402
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LAC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 37AC00826000 (NJ)
Practice location
67 Sanford St
East Orange, NJ 07018-1926
Phone: (973) 673-3342
Fax: (973) 673-5612
Mailing address
54 Polk St Apt O3
Newark, NJ 07105-2880
Registry dates
- Enumerated
- 2024-10-12
- Last updated
- 2024-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.