Provider Demographics
NPI: | 1730515354 |
---|---|
Name: | SCHOLWINSKI, AMANDA (LPC) |
Entity type: | Individual |
Prefix: | |
First Name: | AMANDA |
Middle Name: | |
Last Name: | SCHOLWINSKI |
Suffix: | |
Gender: | F |
Credentials: | LPC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 315 STEELE RD |
Mailing Address - Street 2: | APT. C-17 |
Mailing Address - City: | FEASTERVILLE TREVOSE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19053-4509 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 215-917-1158 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 315 STEELE RD |
Practice Address - Street 2: | APT. C-17 |
Practice Address - City: | FEASTERVILLE TREVOSE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19053-4509 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-917-1158 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2013-09-16 |
Last Update Date: | 2013-09-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | PC007094 | 101YM0800X |
PA | 11626974 | 101YS0200X |
NJ | 898506 | 101YS0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 101YS0200X | Behavioral Health & Social Service Providers | Counselor | School |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 11626974 | Other | PA DEPT. OF EDUCATION |