MEDICARE: AMANDA THOMSON MA, LPC

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
1	101YP2500X	Professional Counselor	PC010833	PA

General Provider Information

NPI Number	:	1679114466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA THOMSON MA, LPC

Provider Business Mailing Address
First Line	:	781 N JUDSON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-2507
Country	:	US
Telephone Number	:	215-282-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 DARBY RD
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-3818
Country	:	US
Telephone Number	:	610-348-6439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	01/09/2026

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Directions to “ AMANDA THOMSON MA, LPC” Practice Location

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