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Organization
SOUTHTOWNS MENTAL HEALTH COUNSELING PC
Active
Organization
SOUTHTOWNS MENTAL HEALTH COUNSELING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BOLIN LMHC (DIRECTOR)
(716) 410-5390
Entity
Organization
Contact information
Practice address
38 LAKE ST, HAMBURG, NY 14075-4951
(716) 410-5390
(716) 422-9011
Mailing address
38 LAKE ST, HAMBURG, NY 14075-4951
(716) 410-5390
(716) 422-9011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
111N00000X
Chiropractor
—
—
163W00000X
Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07665974
—
NY
Enumeration date
05/24/2021
Last updated
02/10/2026
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