Healthcare Provider Details
I. General information
NPI: 1669265153
Provider Name (Legal Business Name): AMANDA BERT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/27/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
176 VIRGINIA AVE
ROCHESTER PA
15074-1723
US
IV. Provider business mailing address
63 PITT ST
SHARON PA
16146-2102
US
V. Phone/Fax
- Phone: 724-770-9095
- Fax: 724-770-9096
- Phone: 724-770-9095
- Fax: 724-770-9096
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | PC018550 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC018550 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: