Provider Demographics
NPI:1669824553
Name:KONIEWICZ, AMANDA (PSYD, LPC, CAADC)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:KONIEWICZ
Suffix:
Gender:F
Credentials:PSYD, LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 PARKLANE RD
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2922
Mailing Address - Country:US
Mailing Address - Phone:484-442-0073
Mailing Address - Fax:
Practice Address - Street 1:600 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2561
Practice Address - Country:US
Practice Address - Phone:484-442-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPMC5844101YM0800X
ID8671445101YM0800X
PAPC012293103TC0700X, 101YP2500X
SC1805101YP2500X
VT068.0136061TELE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional