Provider Demographics
| NPI: | 1730515354 |
|---|---|
| Name: | SCHOLWINSKI, AMANDA (LPC) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | AMANDA |
| Middle Name: | |
| Last Name: | SCHOLWINSKI |
| Suffix: | |
| Gender: | F |
| Credentials: | LPC |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 315 STEELE RD |
| Mailing Address - Street 2: | APT. C-17 |
| Mailing Address - City: | FEASTERVILLE TREVOSE |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 19053-4509 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 215-917-1158 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 315 STEELE RD |
| Practice Address - Street 2: | APT. C-17 |
| Practice Address - City: | FEASTERVILLE TREVOSE |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19053-4509 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 215-917-1158 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2013-09-16 |
| Last Update Date: | 2013-09-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| PA | PC007094 | 101YM0800X |
| PA | 11626974 | 101YS0200X |
| NJ | 898506 | 101YS0200X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
| No | 101YS0200X | Behavioral Health & Social Service Providers | Counselor | School |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 11626974 | Other | PA DEPT. OF EDUCATION |