Provider Demographics
NPI:1326158064
Name:PIKE, AMANDA KATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATHERINE
Last Name:PIKE
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 1:1506 GOODNIGHT CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6214
Mailing Address - Country:US
Mailing Address - Phone:832-282-4592
Mailing Address - Fax:281-499-9360
Practice Address - Street 1:4502 RIVERSTONE BLVD STE 1301
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5212
Practice Address - Country:US
Practice Address - Phone:832-282-4592
Practice Address - Fax:281-499-9360
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166788301Medicaid