Provider Demographics
NPI:1205252780
Name:AMADO, SANDRA JULIANA (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JULIANA
Last Name:AMADO
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 NW 45TH ST
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-1612
Mailing Address - Country:US
Mailing Address - Phone:128-177-3536
Mailing Address - Fax:
Practice Address - Street 1:7037 CAPITOL ST STE N100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4643
Practice Address - Country:US
Practice Address - Phone:713-660-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-08
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health