Provider Demographics
NPI:1295871077
Name:CORKILL, AMANDA COLUNGA (LPC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:COLUNGA
Last Name:CORKILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N BONHAM ST STE 8
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-5309
Mailing Address - Country:US
Mailing Address - Phone:956-399-2740
Mailing Address - Fax:
Practice Address - Street 1:1001 N BONHAM ST STE 8
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-5309
Practice Address - Country:US
Practice Address - Phone:956-399-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18537101YP2500X
TXS21760104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker