Provider Demographics
NPI:1851824031
Name:PRATER, AMANDA LYNN (MRC, LPC, BCB)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:PRATER
Suffix:
Gender:F
Credentials:MRC, LPC, BCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 W ARAPAHO RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4200
Mailing Address - Country:US
Mailing Address - Phone:972-437-9177
Mailing Address - Fax:972-437-9201
Practice Address - Street 1:670 W ARAPAHO RD
Practice Address - Street 2:SUITE 5
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4200
Practice Address - Country:US
Practice Address - Phone:972-437-9177
Practice Address - Fax:972-437-9201
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health