Amanda Knickerbocker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014704 Issued in PA

Practice address

155 Mican Rd
Waymart, PA 18472-3034

Phone

(570) 647-7820

NPI assigned

Aug 6, 2022

Last updated

Aug 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Better Patterns Therapy LLC

  • Professional Counselor
  • Waymart, PA
  • NPI 1467160119
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659744000000",
    "number": "1487381653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MICAN RD",
            "city": "WAYMART",
            "state": "PA",
            "postal_code": "184723034",
            "telephone_number": "570-647-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MICAN RD",
            "city": "WAYMART",
            "state": "PA",
            "postal_code": "184723034",
            "telephone_number": "570-647-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "AMANDA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-06",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Noel Inscoe, MS, WHC
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• Amanda L Kisel, MS, LBS, LSW
• Marci Ann Kowalewski, PAC
• Kathleen Marie Lello
• Michelle Marie Marcho, PTA
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• Professional Counselor in Waymart, PA
• Providers in Waymart, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.