Provider Demographics
NPI:1598482051
Name:AMANDA ALLISON COUNSELING LLC
Entity Type:Organization
Organization Name:AMANDA ALLISON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:614-233-1656
Mailing Address - Street 1:1 SE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2214
Mailing Address - Country:US
Mailing Address - Phone:614-233-1656
Mailing Address - Fax:614-987-4031
Practice Address - Street 1:701 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2331
Practice Address - Country:US
Practice Address - Phone:614-233-1656
Practice Address - Fax:614-987-4031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty