Provider Demographics
NPI:1013632629
Name:WEBSTER, AMANDA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:HERSHBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 711485
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96771-1485
Mailing Address - Country:US
Mailing Address - Phone:808-209-7979
Mailing Address - Fax:
Practice Address - Street 1:688 KINOOLE ST STE 212
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3869
Practice Address - Country:US
Practice Address - Phone:808-209-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-895-0101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health