Provider Demographics
NPI:1174689889
Name:AMATUCCI, MARIA ANGELINA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELINA
Last Name:AMATUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BEECHCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1301
Mailing Address - Country:US
Mailing Address - Phone:717-975-1981
Mailing Address - Fax:
Practice Address - Street 1:121 LOCUST ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-1411
Practice Address - Country:US
Practice Address - Phone:717-238-8118
Practice Address - Fax:717-238-8140
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional