Provider Demographics
NPI:1588768519
Name:FINCHER, AMANDA (LCPC)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:FINCHER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:1470 E WEST SHADY SIDE RD
Mailing Address - Street 2:
Mailing Address - City:SHADY SIDE
Mailing Address - State:MD
Mailing Address - Zip Code:20764-9713
Mailing Address - Country:US
Mailing Address - Phone:443-280-3052
Mailing Address - Fax:
Practice Address - Street 1:645 DEALE RD
Practice Address - Street 2:
Practice Address - City:DEALE
Practice Address - State:MD
Practice Address - Zip Code:20751-2212
Practice Address - Country:US
Practice Address - Phone:410-541-6686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2230101YS0200X, 101YP2500X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDL21775952OtherMARYLAND TAX ID