Healthcare Provider Details
I. General information
NPI: 1851229470
Provider Name (Legal Business Name): AMANDA KATHARINA WEISE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2151 EMRICK BLVD STE 201
BETHLEHEM PA
18020-8039
US
IV. Provider business mailing address
1335 5TH AVE
PHILLIPSBURG NJ
08865-4720
US
V. Phone/Fax
- Phone: 484-537-7515
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | PC019644 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: