Provider Demographics
NPI:1780094946
Name:ASHCRAFT, AMANDA (LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ASHCRAFT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 RESLER DR
Mailing Address - Street 2:1802
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-3056
Mailing Address - Country:US
Mailing Address - Phone:915-845-3122
Mailing Address - Fax:915-845-4165
Practice Address - Street 1:300 THUNDERBIRD DR
Practice Address - Street 2:12
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3829
Practice Address - Country:US
Practice Address - Phone:915-845-3122
Practice Address - Fax:915-845-4165
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX72378101YP2500X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered