Provider Demographics
NPI:1891107041
Name:HERR, AMANDA (LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HERR
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 1:64 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-1512
Mailing Address - Country:US
Mailing Address - Phone:570-723-8033
Mailing Address - Fax:570-723-8044
Practice Address - Street 1:64 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1512
Practice Address - Country:US
Practice Address - Phone:570-723-8033
Practice Address - Fax:570-723-8044
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2024-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional