Provider Demographics
NPI:1639437601
Name:PARSONS, AMANDA CAROL (LPCC-S)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CAROL
Last Name:PARSONS
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 TRENT BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517
Mailing Address - Country:US
Mailing Address - Phone:859-533-2562
Mailing Address - Fax:
Practice Address - Street 1:1025 DOVE RUN RD STE 307
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3588
Practice Address - Country:US
Practice Address - Phone:859-533-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1396101YM0800X
KY105799101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100332350Medicaid