Provider Demographics
NPI:1518850122
Name:WAGNER, AMANDA HARLACHER (LSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:HARLACHER
Last Name:WAGNER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:HARLACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:966 SHENANDOAH LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1211
Mailing Address - Country:US
Mailing Address - Phone:717-858-2108
Mailing Address - Fax:
Practice Address - Street 1:3130 GRANDVIEW RD STE F
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-8527
Practice Address - Country:US
Practice Address - Phone:717-969-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker