Provider Demographics
NPI:1558011189
Name:MAYO, AMANDA F (MS, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:F
Last Name:MAYO
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 GABRIEL CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-6856
Mailing Address - Country:US
Mailing Address - Phone:770-653-4531
Mailing Address - Fax:
Practice Address - Street 1:309 PIRKLE FERRY RD STE C200
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2550
Practice Address - Country:US
Practice Address - Phone:770-653-4531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-26
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YP2500X
GALPC012864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional