Provider Demographics
NPI:1245078963
Name:GIL, AMANDA RENEE (LMHC LP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:GIL
Suffix:
Gender:F
Credentials:LMHC LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10235 64TH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1545
Mailing Address - Country:US
Mailing Address - Phone:347-934-6794
Mailing Address - Fax:
Practice Address - Street 1:10235 64TH RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1545
Practice Address - Country:US
Practice Address - Phone:347-934-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP120807101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health