Provider Demographics
NPI:1003678004
Name:KINER, AMANDA CS (LPC, CPCS, NCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CS
Last Name:KINER
Suffix:
Gender:F
Credentials:LPC, CPCS, NCC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CARIANN
Other - Last Name:SWORDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1030 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-3202
Mailing Address - Country:US
Mailing Address - Phone:770-313-7479
Mailing Address - Fax:
Practice Address - Street 1:15320 HWY 129
Practice Address - Street 2:
Practice Address - City:ALAPAHA
Practice Address - State:GA
Practice Address - Zip Code:31622-7351
Practice Address - Country:US
Practice Address - Phone:229-213-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional