Provider Demographics
NPI:1154433696
Name:POMAYBO, AMY L (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:POMAYBO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4955
Mailing Address - Country:US
Mailing Address - Phone:724-498-7354
Mailing Address - Fax:724-297-5670
Practice Address - Street 1:127 S MCKEAN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-6029
Practice Address - Country:US
Practice Address - Phone:888-924-3627
Practice Address - Fax:724-297-5670
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0153691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical