Provider Demographics
NPI:1568853661
Name:FORSTING, AMANDA (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:FORSTING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SIMPSON WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99712-1096
Mailing Address - Country:US
Mailing Address - Phone:970-616-9950
Mailing Address - Fax:907-921-5098
Practice Address - Street 1:3550 AIRPORT WAY STE 4
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4772
Practice Address - Country:US
Practice Address - Phone:907-479-2331
Practice Address - Fax:907-921-5098
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18638101YM0800X
CO0019156101YM0800X
AK202632101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health