Provider Demographics
NPI:1396208302
Name:AMANDA HEANEY, LPC
Entity Type:Organization
Organization Name:AMANDA HEANEY, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:HEANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-259-7443
Mailing Address - Street 1:3033 NW 63RD ST
Mailing Address - Street 2:SUITE 160 EAST
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73116
Mailing Address - Country:US
Mailing Address - Phone:405-259-7443
Mailing Address - Fax:405-421-0719
Practice Address - Street 1:3033 NW 63RD ST
Practice Address - Street 2:SUITE 160 EAST
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-259-7443
Practice Address - Fax:405-421-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty