Provider Demographics
NPI:1710394820
Name:DOOLEY, AMANDA (LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVALE
Mailing Address - State:TN
Mailing Address - Zip Code:37153-4681
Mailing Address - Country:US
Mailing Address - Phone:615-485-8352
Mailing Address - Fax:
Practice Address - Street 1:567 CASON LN STE A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-4871
Practice Address - Country:US
Practice Address - Phone:615-900-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3612101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ026337Medicaid