Provider Demographics
NPI:1528579299
Name:CHILS, AMANDA (LCMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CHILS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 NC HIGHWAY 42 S
Mailing Address - Street 2:
Mailing Address - City:RAMSEUR
Mailing Address - State:NC
Mailing Address - Zip Code:27316-8211
Mailing Address - Country:US
Mailing Address - Phone:336-937-0716
Mailing Address - Fax:
Practice Address - Street 1:7106 NC HIGHWAY 42 S
Practice Address - Street 2:
Practice Address - City:RAMSEUR
Practice Address - State:NC
Practice Address - Zip Code:27316-8211
Practice Address - Country:US
Practice Address - Phone:336-937-0716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-20
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12561101YA0400X, 2084P0802X
NC12561101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry