Healthcare Provider Details

I. General information

NPI: 1295613552
Provider Name (Legal Business Name): AMANDA MARIE RYCZEK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 STONEWOOD DR STE 300
WEXFORD PA
15090-8326
US

IV. Provider business mailing address

18 HILLCREST DR APT 2
BELLEVUE PA
15202-2950
US

V. Phone/Fax

Practice location:
  • Phone: 724-934-3905
  • Fax:
Mailing address:
  • Phone: 724-912-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: