Provider Demographics
NPI:1932319811
Name:HARRINGTON, AMANDA DIANE (LMFT)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:DIANE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHICKASAW NATION MEDICAL CENTER
Mailing Address - Street 2:1921 STONECIPHER BLVD.
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-3980
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:1438 HARDCASTLE BLVD.
Practice Address - Street 2:MEDICAL FAMILY THERAPY
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080
Practice Address - Country:US
Practice Address - Phone:405-527-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201101106H00000X
OK1052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist