Provider Demographics
NPI:1669062535
Name:JUHASZ, AMANDA KATHLEEN (LCPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATHLEEN
Last Name:JUHASZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5989 S CHESHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6996
Mailing Address - Country:US
Mailing Address - Phone:208-890-9588
Mailing Address - Fax:
Practice Address - Street 1:5989 S CHESHIRE AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-6996
Practice Address - Country:US
Practice Address - Phone:208-890-9588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-24
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC7245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty