Provider Demographics
NPI:1275833493
Name:AUSTIN, AMANDA KRISTINA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KRISTINA
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:ARGOS
Mailing Address - State:IN
Mailing Address - Zip Code:46501-1016
Mailing Address - Country:US
Mailing Address - Phone:574-276-5586
Mailing Address - Fax:
Practice Address - Street 1:503 E FORT WAYNE ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3338
Practice Address - Country:US
Practice Address - Phone:574-267-2906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002086A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health