Provider Demographics
NPI:1750048047
Name:NEACE, AMANDA LEE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:NEACE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 W PROSPECT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-6341
Mailing Address - Country:US
Mailing Address - Phone:724-713-1781
Mailing Address - Fax:
Practice Address - Street 1:4160 WASHINGTON RD STE 217
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2533
Practice Address - Country:US
Practice Address - Phone:724-713-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014005101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health