Individual provider · Type 1 NPI

Amanda Lauren Malandruccolo

Mental Health Counselor · Massapequa, NY

NPI number 1174406045 Active

Practice location

727 N Broadway Ste C1
Massapequa, NY 11758-2348

Mailing address

1891 Leslie Ln
Merrick, NY 11566-5211

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XP137255 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1174406045

Amanda Lauren Malandruccolo's National Provider Identifier is 1174406045, issued on Jul 29, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Massapequa, NY. The record was last updated on Jul 29, 2025.