Provider Demographics
NPI:1790120095
Name:GREEN-HARRINGTON, AMANDA DE'NEE (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DE'NEE
Last Name:GREEN-HARRINGTON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 RONALD REAGAN DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1651
Mailing Address - Country:US
Mailing Address - Phone:910-670-3670
Mailing Address - Fax:
Practice Address - Street 1:907 HAY ST STE 201
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5352
Practice Address - Country:US
Practice Address - Phone:910-483-5986
Practice Address - Fax:910-483-2876
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9277101YP2500X
NCLCAS-20070101YA0400X
NC9277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)