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NPI Code Detail

MEDICARE: AMANDA WHITE LMHC10001253

MEDICARE: AMANDA WHITE LMHC10001253
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YM0800XMental Health CounselorLMHC10001253MA

General Provider Information

NPI Number : 1043835168
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA WHITE LMHC10001253
Provider Business Mailing Address
First Line : 1125 CENTRE ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-3495
Country : US
Telephone Number : 339-777-2294
Fax Number :
Provider Business Practice Location Address
First Line : 1125 CENTRE ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-3495
Country : US
Telephone Number : 339-777-2294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2020
Last Update Date : 02/21/2025

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Directions to “ AMANDA WHITE LMHC10001253” Practice Location

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