Provider Demographics
NPI:1588243828
Name:GEIBEL, AMANDA N (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:N
Last Name:GEIBEL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:GEIBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:458 BEAGLE CLUB RD
Mailing Address - Street 2:
Mailing Address - City:COWANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16218-2018
Mailing Address - Country:US
Mailing Address - Phone:724-841-1752
Mailing Address - Fax:
Practice Address - Street 1:4001 STONEWOOD DR STE 110
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8398
Practice Address - Country:US
Practice Address - Phone:724-747-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health