Provider Demographics
NPI:1427772128
Name:WINTER, EMILY AURORA (LAC, NCC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:AURORA
Last Name:WINTER
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LAKESIDE AVE UNIT 403
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1648
Mailing Address - Country:US
Mailing Address - Phone:973-513-5682
Mailing Address - Fax:
Practice Address - Street 1:21 LAKESIDE AVE UNIT 403
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1648
Practice Address - Country:US
Practice Address - Phone:973-513-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC000604900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health