Provider Demographics
NPI:1053170860
Name:AMY DEGIROLAMO LLC THERAPY
Entity type:Organization
Organization Name:AMY DEGIROLAMO LLC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGIROLAMO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:609-221-1625
Mailing Address - Street 1:442 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3130
Mailing Address - Country:US
Mailing Address - Phone:609-221-1625
Mailing Address - Fax:
Practice Address - Street 1:442 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3130
Practice Address - Country:US
Practice Address - Phone:609-221-1625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty