Provider Demographics
NPI:1942988621
Name:TRIMBLE, AMANDA (MS, LPC, NCC, CAADC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:MS, LPC, NCC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:PA
Mailing Address - Zip Code:17752-9541
Mailing Address - Country:US
Mailing Address - Phone:570-447-9183
Mailing Address - Fax:
Practice Address - Street 1:360 WHITE DEER RUN RD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810-9268
Practice Address - Country:US
Practice Address - Phone:800-255-2335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional