Provider Demographics
NPI:1235848003
Name:ADAMS, AMANDA ERIN (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ERIN
Last Name:ADAMS
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 1:17488 LANCE LN
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762-2502
Mailing Address - Country:US
Mailing Address - Phone:512-826-6667
Mailing Address - Fax:
Practice Address - Street 1:17488 LANCE LN
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-2502
Practice Address - Country:US
Practice Address - Phone:512-826-6667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional