Provider Demographics
NPI:1679889083
Name:DRAUGHN, AMANDA (LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:DRAUGHN
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 1:250 GILMER MILLER RD
Mailing Address - Street 2:
Mailing Address - City:LOWGAP
Mailing Address - State:NC
Mailing Address - Zip Code:27024-7323
Mailing Address - Country:US
Mailing Address - Phone:336-710-6142
Mailing Address - Fax:
Practice Address - Street 1:319 S MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4715
Practice Address - Country:US
Practice Address - Phone:336-756-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional