Provider Demographics
NPI:1699163667
Name:WITTENAUER, AMBER LYNN (MA - AT - LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:WITTENAUER
Suffix:
Gender:F
Credentials:MA - AT - LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 HOWELL DR
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2459
Mailing Address - Country:US
Mailing Address - Phone:412-418-8224
Mailing Address - Fax:
Practice Address - Street 1:530 BLACKHAWK RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1410
Practice Address - Country:US
Practice Address - Phone:724-396-1510
Practice Address - Fax:724-972-4627
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007912101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional