Provider Demographics
NPI:1932490935
Name:KESSLER, AMANDA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:KESSLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:LEE
Other - Last Name:RICKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LBSC
Mailing Address - Street 1:3413 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-2747
Mailing Address - Country:US
Mailing Address - Phone:717-324-4846
Mailing Address - Fax:
Practice Address - Street 1:3413 CARDINAL LN
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-2747
Practice Address - Country:US
Practice Address - Phone:717-324-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002661174400000X
PACW0203031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist