Provider Demographics
NPI:1417588856
Name:WEBRECK, AMANDA EUN JEE (PHD, MS, BA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:EUN JEE
Last Name:WEBRECK
Suffix:
Gender:F
Credentials:PHD, MS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 WHITE HORSE RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15530-5614
Mailing Address - Country:US
Mailing Address - Phone:910-546-4175
Mailing Address - Fax:
Practice Address - Street 1:445 WESTRIDGE RD STE 103
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1157
Practice Address - Country:US
Practice Address - Phone:814-444-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor