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General NPI Number Information
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NPI Number | 1871452086
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Entity Type | Individual
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Provider Name | AMANDA CECILIA PENA LSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 2424 E YORK ST STE 301A
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3049
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Country | US
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Telephone | 215-469-1668
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Fax |
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Provider Business Mailing Address
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Address Line | 2290 W OREGON AVE # 1186
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City | PHILADELPHIA
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State | PA
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Zip | 19145-4197
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Country | US
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Telephone |
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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 | SW139142
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License Number State | PA
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