Provider Demographics
NPI:1629208970
Name:RILLA, AMANDA (LMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RILLA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:RILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:193 LOCUST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2065
Mailing Address - Country:US
Mailing Address - Phone:413-584-8700
Mailing Address - Fax:413-517-2226
Practice Address - Street 1:193 LOCUST ST STE 2
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2065
Practice Address - Country:US
Practice Address - Phone:134-584-8700
Practice Address - Fax:134-584-1714
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1559101YM0800X
MA10559101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health