Provider Demographics
NPI:1578441630
Name:BELTON, WAYNNE AMADA (MA, LAC)
Entity type:Individual
Prefix:MRS
First Name:WAYNNE
Middle Name:AMADA
Last Name:BELTON
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 1:9 GRAY ST
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7605
Mailing Address - Country:US
Mailing Address - Phone:973-902-5253
Mailing Address - Fax:
Practice Address - Street 1:999 RIVERVIEW DR STE 201
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1165
Practice Address - Country:US
Practice Address - Phone:551-276-8291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00898300106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist