Provider Demographics
NPI:1033699756
Name:ROBERTS, AMANDA CLORESSA (LMFT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CLORESSA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-1957
Mailing Address - Country:US
Mailing Address - Phone:412-607-3608
Mailing Address - Fax:412-267-5288
Practice Address - Street 1:4712 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-1957
Practice Address - Country:US
Practice Address - Phone:412-607-3608
Practice Address - Fax:412-267-5288
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist