Provider Demographics
NPI:1376904052
Name:BIHARI, AMANDA (LPCC-)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BIHARI
Suffix:
Gender:F
Credentials:LPCC-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1293
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-8793
Mailing Address - Country:US
Mailing Address - Phone:216-200-8637
Mailing Address - Fax:
Practice Address - Street 1:912 N CARPENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-2238
Practice Address - Country:US
Practice Address - Phone:216-200-8637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1400100101YP2500X
OHE.1700439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC1400100OtherSTATE LICENSE