Provider Demographics
NPI:1699172130
Name:JANULIS, AMANDA BETH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:BETH
Last Name:JANULIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BETSY LN
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5733
Mailing Address - Country:US
Mailing Address - Phone:215-287-6690
Mailing Address - Fax:
Practice Address - Street 1:32 BETSY LN
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5733
Practice Address - Country:US
Practice Address - Phone:215-287-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061127001041C0700X
PACW014691101Y00000X, 1041C0700X
MA1247791041C0700X
NCC0148171041C0700X
DEQ1-00120261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor