Healthcare Provider Details

I. General information

NPI: 1801562046
Provider Name (Legal Business Name): AMANDA SHPIGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FRANKLIN ST STE 204
SCHENECTADY NY
12305-2100
US

IV. Provider business mailing address

587 BROADWAY APT H22
MENANDS NY
12204-2864
US

V. Phone/Fax

Practice location:
  • Phone: 518-372-7031
  • Fax: 518-372-7064
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP112580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: