Provider Demographics
NPI:1689784597
Name:AMAISMEIER, PAULINE (MS, LPC, NCC, RN- BC)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:AMAISMEIER
Suffix:
Gender:F
Credentials:MS, LPC, NCC, RN- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 WASHINGTON RD STE 217
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2533
Mailing Address - Country:US
Mailing Address - Phone:724-914-1252
Mailing Address - Fax:888-244-7140
Practice Address - Street 1:4160 WASHINGTON RD STE 217
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2533
Practice Address - Country:US
Practice Address - Phone:724-914-1252
Practice Address - Fax:888-244-7140
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005009101YP2500X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102433210Medicaid