Provider Demographics
NPI:1497308290
Name:MORIN, AMANDA MARIA (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIA
Last Name:MORIN
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 LONG PRAIRIE TRCE APT 217
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1771
Mailing Address - Country:US
Mailing Address - Phone:281-673-9990
Mailing Address - Fax:
Practice Address - Street 1:707 S FRY RD STE 465
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2259
Practice Address - Country:US
Practice Address - Phone:281-940-8515
Practice Address - Fax:888-972-1582
Is Sole Proprietor?:No
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherN/A