Provider Demographics
NPI:1801529763
Name:JOVE VIVES, AMANDA PAOLA (LPC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:PAOLA
Last Name:JOVE VIVES
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 1:1161 GENTRY DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-1641
Mailing Address - Country:US
Mailing Address - Phone:787-413-3193
Mailing Address - Fax:
Practice Address - Street 1:1161 GENTRY DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-1641
Practice Address - Country:US
Practice Address - Phone:615-819-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional