Provider Demographics
NPI:1235520610
Name:AMANDA COLLINS, MA, LMFT, PLLC
Entity Type:Organization
Organization Name:AMANDA COLLINS, MA, LMFT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:210-461-2214
Mailing Address - Street 1:500 N LOOP 1604 E STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1239
Mailing Address - Country:US
Mailing Address - Phone:210-461-2214
Mailing Address - Fax:210-496-0101
Practice Address - Street 1:500 N LOOP 1604 E STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1239
Practice Address - Country:US
Practice Address - Phone:210-461-2214
Practice Address - Fax:210-496-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201615106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty