Provider Demographics
NPI:1376002956
Name:CHANCE, AMANDA KIM DENBO (MBA, MSC, NCC, LPC-S)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KIM DENBO
Last Name:CHANCE
Suffix:
Gender:F
Credentials:MBA, MSC, NCC, LPC-S
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KIM
Other - Last Name:DENBO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MANDEE
Mailing Address - Street 1:1014 N COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1014 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4239
Practice Address - Country:US
Practice Address - Phone:520-222-9458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-17855101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health