Provider Demographics
NPI:1801511449
Name:AMANDA H. SALTZBERG LMHC
Entity type:Organization
Organization Name:AMANDA H. SALTZBERG LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SALTZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-274-9570
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:WEST TISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02575-0174
Mailing Address - Country:US
Mailing Address - Phone:508-274-9570
Mailing Address - Fax:
Practice Address - Street 1:10 ELIAKIMS WAY
Practice Address - Street 2:
Practice Address - City:WEST TISBURY
Practice Address - State:MA
Practice Address - Zip Code:02575-5285
Practice Address - Country:US
Practice Address - Phone:508-274-9570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty