Provider Demographics
NPI:1689711608
Name:WEBBER, AMANDA KATHRYN I (MA,LMHC LPCC,ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:KATHRYN
Last Name:WEBBER
Suffix:I
Gender:F
Credentials:MA,LMHC LPCC,ATR-BC
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:KATHRYN
Other - Last Name:WEBBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:39 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1225
Mailing Address - Country:US
Mailing Address - Phone:442-400-9195
Mailing Address - Fax:
Practice Address - Street 1:7293 DUMOSA AVE STE 8
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3700
Practice Address - Country:US
Practice Address - Phone:760-369-7166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health