Provider Demographics
NPI:1467812453
Name:WASSERMAN, AMANDA B (LCMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 GOLF CLUB CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-8828
Mailing Address - Country:US
Mailing Address - Phone:542-966-7999
Mailing Address - Fax:
Practice Address - Street 1:2320 GOLF CLUB CT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-8828
Practice Address - Country:US
Practice Address - Phone:954-296-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15229101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health