Provider Demographics
NPI:1942569884
Name:CINCEVICH, AMANDA EILEEN (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:EILEEN
Last Name:CINCEVICH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PROSPECT ST.
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-883-1568
Practice Address - Street 1:15 PROSPECT ST.
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-883-1568
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health