Provider Demographics
NPI:1194695114
Name:DADETTO, ANDREA (MA, LAC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:DADETTO
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3926
Mailing Address - Country:US
Mailing Address - Phone:856-433-4264
Mailing Address - Fax:
Practice Address - Street 1:14 NASSAU AVE
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3926
Practice Address - Country:US
Practice Address - Phone:856-433-4264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00803400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health