Provider Demographics
NPI:1396593836
Name:CHIPMAN, AMANDA KATHLEEN (LIMHP, LPC, LCMHC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATHLEEN
Last Name:CHIPMAN
Suffix:
Gender:F
Credentials:LIMHP, LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 LONGVIEW ST # B-103
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-2538
Mailing Address - Country:US
Mailing Address - Phone:402-314-4713
Mailing Address - Fax:
Practice Address - Street 1:2323 AVENUE J E
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-2789
Practice Address - Country:US
Practice Address - Phone:402-522-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20100101YM0800X
SC9652101YM0800X
NE3180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health