Provider Demographics
NPI:1780196352
Name:AMANDA SELLERS, PSY.D., LLC
Entity Type:Organization
Organization Name:AMANDA SELLERS, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:484-809-0529
Mailing Address - Street 1:121 N. CEDAR CREST BLVD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4664
Mailing Address - Country:US
Mailing Address - Phone:484-809-0529
Mailing Address - Fax:610-351-4124
Practice Address - Street 1:121 N. CEDAR CREST BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4664
Practice Address - Country:US
Practice Address - Phone:484-809-0529
Practice Address - Fax:610-351-4124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty