Healthcare Provider Details

I. General information

NPI: 1780366997
Provider Name (Legal Business Name): AMY LYNN BUEHRER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 S 8TH ST
DU BOIS PA
15801-2847
US

IV. Provider business mailing address

144 MEMORIAL PARK RD
SYKESVILLE PA
15865-1414
US

V. Phone/Fax

Practice location:
  • Phone: 814-661-6870
  • Fax:
Mailing address:
  • Phone: 814-661-6870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW126371
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW126371
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: