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General NPI Number Information
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NPI Number | 1750794848
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Entity Type | Individual
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Provider Name | AMANDA NICOLE KAPES L.S.W. & BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 10/26/2024
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Provider Practice Location Address
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Address Line | 679 KIDDER ST STE 8
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City | WILKES BARRE TOWNSHIP
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State | PA
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Zip | 18702-6973
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Country | US
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Telephone | 570-266-0651
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Fax |
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Provider Business Mailing Address
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Address Line | 209 FOUR SEASONS DR
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City | DRUMS
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State | PA
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Zip | 18222-1227
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Country | US
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Telephone | 570-956-6946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW129649
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-73479
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License Number State | PA
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