IndividualActive
Amanda Waller, LPC
NPI 1710590146 · Professional Counselor · Eatontown, NJ
Provider details
- NPI number
- 1710590146
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 37PC00637200 (NJ)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
154 Waypoint Dr
Eatontown, NJ 07724-2184
Phone: (908) 310-7788
Approximate (ZIP-level) locationGet directions
Mailing address
409 South Street Po Box 1111
Eatontown, NJ 07724-4111
Registry dates
- Enumerated
- 2020-08-25
- Last updated
- 2022-12-09
- Certified
- 2022-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.