Provider Demographics
NPI:1508187444
Name:KUSHNER, AMANDA (LPC, CCTP, NCGC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:LPC, CCTP, NCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 THOMSON PARK DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6434
Mailing Address - Country:US
Mailing Address - Phone:724-591-8913
Mailing Address - Fax:724-591-8909
Practice Address - Street 1:314 THOMSON PARK DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6434
Practice Address - Country:US
Practice Address - Phone:724-591-8913
Practice Address - Fax:724-591-8909
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional