Healthcare Provider Details

I. General information

NPI: 1932038841
Provider Name (Legal Business Name): MISS AMANDA L LABLANC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 VALLEY ST
LEE MA
01238-7701
US

IV. Provider business mailing address

45 HIGH ST
PITTSFIELD MA
01201-7005
US

V. Phone/Fax

Practice location:
  • Phone: 413-242-2028
  • Fax:
Mailing address:
  • Phone: 413-242-2028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: