Provider Demographics
NPI:1427487834
Name:RADLEY, AMANDA R (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:RADLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:R
Other - Last Name:BLANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1400 SWEET HOME RD STE 6
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2777
Mailing Address - Country:US
Mailing Address - Phone:716-810-9093
Mailing Address - Fax:
Practice Address - Street 1:1400 SWEET HOME RD STE 6
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2777
Practice Address - Country:US
Practice Address - Phone:716-810-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health