Provider Demographics
NPI:1790200764
Name:NAVA, AMELIA LEIGH (LCMHC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:LEIGH
Last Name:NAVA
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:LEIGH
Other - Last Name:MITTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LCMHCA
Mailing Address - Street 1:412 WEDGEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:131 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4453
Practice Address - Country:US
Practice Address - Phone:828-785-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12640101YM0800X
NC12640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health