Individual
AMANDA PATRICIA LEIBOVITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, LMHC, CMPC
Contact information
Practice address
508 BRASSTOWN CT, PENDLETON, SC 29670-1877
(847) 571-8406
Mailing address
508 BRASSTOWN CT, PENDLETON, SC 29670-1877
(847) 571-8406
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH61357194
WA
101YP2500X
Professional Counselor
9114
SC
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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