Provider Demographics
NPI:1710394390
Name:PRICE, AMANDA (LMHP, LPC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMHP, LPC
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHP LPC
Mailing Address - Street 1:502 HENKENS DR
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2450
Mailing Address - Country:US
Mailing Address - Phone:308-430-1944
Mailing Address - Fax:775-667-6079
Practice Address - Street 1:212 BORDEAUX ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2344
Practice Address - Country:US
Practice Address - Phone:308-430-1944
Practice Address - Fax:775-667-6079
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health