Individual
MS. AMANDA A. MCLEISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCJP, CIS
Contact information
Practice address
2121 7TH ST, PARKERSBURG, WV 26101-3803
(304) 485-1721
(304) 485-6710
Mailing address
7000 COUNTY 9 ROAD, NEWPORT, OH 45768
(740) 473-9130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
06-211
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-211
WV CIS CERTIFICATION
WV
01
—
06-741
WV CCJP CERTIFICATION
WV
Enumeration date
04/10/2007
Last updated
07/08/2007
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