Provider Demographics
NPI:1265180475
Name:SEIBERT, AMANDA (MA, RMHCI)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:MA, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 LITTLE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1715
Mailing Address - Country:US
Mailing Address - Phone:727-755-3251
Mailing Address - Fax:
Practice Address - Street 1:4109 LITTLE RD STE 102
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1715
Practice Address - Country:US
Practice Address - Phone:727-755-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health