Provider Demographics
NPI:1003838400
Name:KIZER, AMANDA C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:C
Last Name:KIZER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 DRAFT AVENUE
Mailing Address - Street 2:
Mailing Address - City:STUART'S DRAFT
Mailing Address - State:VA
Mailing Address - Zip Code:24477-6712
Mailing Address - Country:US
Mailing Address - Phone:540-908-2156
Mailing Address - Fax:
Practice Address - Street 1:JENNIFER HATTER LPC AND ASSOCIATES 264 DRAFT AVENUE
Practice Address - Street 2:
Practice Address - City:STUART'S DRAFT
Practice Address - State:VA
Practice Address - Zip Code:24477-6712
Practice Address - Country:US
Practice Address - Phone:540-908-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003718101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA088067MOtherSENTARA
VA004945336Medicaid