Healthcare Provider Details
I. General information
NPI: 1427797588
Provider Name (Legal Business Name): AMIE FEDERICO ATR-BC, CBIS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/27/2022
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
239 4TH AVE STE 1801
PITTSBURGH PA
15222-1716
US
IV. Provider business mailing address
50 LEEMAN ST
EASTON PA
18045-6053
US
V. Phone/Fax
- Phone: 412-532-1249
- Fax:
- Phone: 484-896-8895
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC011457 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | PC011457 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: