Provider Demographics
NPI:1962883504
Name:AMANDA M. HUMMEL
Entity type:Organization
Organization Name:AMANDA M. HUMMEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-452-1196
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:ELYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17824-0185
Mailing Address - Country:US
Mailing Address - Phone:570-452-1196
Mailing Address - Fax:
Practice Address - Street 1:414 W CENTER ST
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-7113
Practice Address - Country:US
Practice Address - Phone:570-452-1196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty