Provider Demographics
NPI:1093976524
Name:KLEIN, AMANDA CHERIE ALEXANDER (MED, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHERIE ALEXANDER
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E SEEMAN ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1962
Mailing Address - Country:US
Mailing Address - Phone:919-357-6973
Mailing Address - Fax:
Practice Address - Street 1:2435 LYNN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6755
Practice Address - Country:US
Practice Address - Phone:919-357-6973
Practice Address - Fax:919-845-4714
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7019101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional