Provider Demographics
NPI:1083965362
Name:SEALEY, AMANDA ROCHELLE (LIMHP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ROCHELLE
Last Name:SEALEY
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 COUNTY ROAD A
Mailing Address - Street 2:
Mailing Address - City:HOOPER
Mailing Address - State:NE
Mailing Address - Zip Code:68031-2165
Mailing Address - Country:US
Mailing Address - Phone:308-325-5075
Mailing Address - Fax:
Practice Address - Street 1:1941 COUNTY ROAD A
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:NE
Practice Address - Zip Code:68031-2165
Practice Address - Country:US
Practice Address - Phone:308-325-5075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4352101YM0800X
NE9658101YM0800X
NE2115101YP2500X
NE1373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional