Provider Demographics
NPI:1588965040
Name:D'ADDONA, MICHAEL A (MA, LPC, CCMHC, NCC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:D'ADDONA
Suffix:
Gender:M
Credentials:MA, LPC, CCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 RUES LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5699
Mailing Address - Country:US
Mailing Address - Phone:732-257-6100
Mailing Address - Fax:732-651-9834
Practice Address - Street 1:288 RUES LN
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5699
Practice Address - Country:US
Practice Address - Phone:732-257-6100
Practice Address - Fax:732-651-9834
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00416400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional