Provider Demographics
NPI:1639426539
Name:HABOVICK, AMANDA ANN (BA)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:ANN
Last Name:HABOVICK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KENSINGTON SQ
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6443
Mailing Address - Country:US
Mailing Address - Phone:724-335-9733
Mailing Address - Fax:
Practice Address - Street 1:3 KENSINGTON SQ
Practice Address - Street 2:SUITE B
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6443
Practice Address - Country:US
Practice Address - Phone:724-335-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007624160018Medicaid