Provider Demographics
NPI:1235897513
Name:SANCHEZ, AMANDA DE JESUS (MS,LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:DE JESUS
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11340 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2208
Mailing Address - Country:US
Mailing Address - Phone:786-406-0782
Mailing Address - Fax:
Practice Address - Street 1:700 S ROYAL POINCIANA BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-6600
Practice Address - Country:US
Practice Address - Phone:786-406-0782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19967101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health