Active NPI
Amanda Will
- Professional Counselor
- Erie, PA
National Provider Identifier
1740603299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC007250
- Practice address
- 4934 Peach St
Erie, PA 16509-2043 - Phone
- (814) 824-4515
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC007250 | PA | Primary |
Addresses
Primary practice location
4934 Peach St
Erie, PA 16509-2043
Mailing address
3417 Allegheny Rd
Erie, PA 16508-2126
Phone (814) 520-2594
Other practice location 1
2420 W 23rd St
Erie, PA 16506-2921
Phone (814) 459-2755 ext. 1165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 6, 2024 through Jun 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC007250 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1740603299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3417 ALLEGHENY RD",
"city": "ERIE",
"state": "PA",
"postal_code": "165082126",
"telephone_number": "814-520-2594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4934 PEACH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165092043",
"telephone_number": "814-824-4515"
}
],
"practiceLocations": [
{
"address_1": "2420 W 23rd St",
"address_purpose": "LOCATION",
"city": "Erie",
"state": "PA",
"postal_code": "165062921",
"country_code": "US",
"telephone_number": "814-459-2755 x1165",
"fax_number": "814-456-4873",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILL",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-03",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC007250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.