Provider Demographics
NPI:1790500734
Name:FIELD, AMANDA LEE (LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:FIELD
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 1:3225 N GRAPEVINE MILLS BLVD APT 2105
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-0979
Mailing Address - Country:US
Mailing Address - Phone:815-370-3070
Mailing Address - Fax:
Practice Address - Street 1:1420 ROBINSON RD STE 400
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-2848
Practice Address - Country:US
Practice Address - Phone:972-523-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional