Provider Demographics
NPI:1225371214
Name:HALL, AMANDA KAYE (LPCA)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:KAYE
Last Name:HALL
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1429
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-1429
Mailing Address - Country:US
Mailing Address - Phone:502-538-1200
Mailing Address - Fax:502-538-1201
Practice Address - Street 1:300 HOPE ST
Practice Address - Street 2:
Practice Address - City:MOUNT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7757
Practice Address - Country:US
Practice Address - Phone:502-538-1200
Practice Address - Fax:502-538-1201
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health