Healthcare Provider Details

I. General information

NPI: 1750213898
Provider Name (Legal Business Name): AMANDA MARIE THOMPSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S RIVER ST STE 203
PLAINS PA
18705-1137
US

IV. Provider business mailing address

PO BOX 1062
KINGSTON PA
18704-0062
US

V. Phone/Fax

Practice location:
  • Phone: 570-290-8603
  • Fax: 888-649-2818
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW144198
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: