Amanda Wagner, PSY.D., LPC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

35SI00692600 Issued in NJ

Practice address

49 E Midland Ave
Paramus, NJ 07652-2920

Phone

(201) 921-0256

NPI assigned

Apr 2, 2016

Last updated

Jan 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Copeland Counseling

  • Clinical Social Worker
  • Rochelle Park, NJ
  • NPI 1932856911

  Professional

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672531200000",
    "number": "1144683574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 184",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074630184",
            "telephone_number": "201-921-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E MIDLAND AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522920",
            "telephone_number": "201-921-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-02",
        "last_updated": "2023-01-01",
        "certification_date": "2023-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00547200",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NJ",
            "license": "35SI00692600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalia Vives, OTR/L
• Christine Vivolo, PA
• Samantha Grace Voltmer, LSW
• Krina A Vyas, M.D.
• Rushikesh Harishkumar Vyas, MD
• Jenniffer Wahler
• Jessica Waldron, LPC
• Irene Bala Walker, APN, FNP-C
• Samantha Brooke Walker, OTR/L
• Adam Wang, DPT

• Counseling Psychologist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Counseling Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.