Healthcare Provider Details

I. General information

NPI: 1245900430
Provider Name (Legal Business Name): AMANDA MARIE SYPIEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 TERENCE DR STE 302
PITTSBURGH PA
15236-4148
US

IV. Provider business mailing address

3320 WILLETT RD
PITTSBURGH PA
15227-3045
US

V. Phone/Fax

Practice location:
  • Phone: 412-945-0692
  • Fax: 412-774-2627
Mailing address:
  • Phone: 412-979-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC013676
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: