Provider Demographics
NPI:1245779198
Name:HORVET, AMANDA LYANN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYANN
Last Name:HORVET
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 W NORTH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:IL
Mailing Address - Zip Code:62839-1293
Mailing Address - Country:US
Mailing Address - Phone:618-662-8494
Mailing Address - Fax:618-662-9519
Practice Address - Street 1:832 W NORTH AVE STE C
Practice Address - Street 2:
Practice Address - City:FLORA
Practice Address - State:IL
Practice Address - Zip Code:62839-1293
Practice Address - Country:US
Practice Address - Phone:618-662-8494
Practice Address - Fax:618-662-9519
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X
IL1-22-58878103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health