Active NPI
Amelia Khalil, LCADC
- Addiction (Substance Use Disorder) Counselor
- Teaneck, NJ
National Provider Identifier
1881210045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 37LC00271700
- Practice address
- 961 Teaneck Rd
Teaneck, NJ 07666-4510 - Phone
- (201) 749-2987
- Fax
- (201) 833-4455
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00271700 | NJ | Primary |
Addresses
Primary practice location
961 Teaneck Rd
Teaneck, NJ 07666-4510
Mailing address
405 Union Ave
Rutherford, NJ 07070-1416
Phone (201) 741-8308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00271700 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1881210045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 UNION AVE",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "070701416",
"telephone_number": "201-741-8308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "961 TEANECK RD",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664510",
"telephone_number": "201-749-2987",
"fax_number": "201-833-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIL",
"first_name": "AMELIA",
"name_prefix": "Mrs.",
"credential": "LCADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37LC00271700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.