Provider Demographics
NPI:1841678521
Name:BARLOW, AMANDA MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:BARLOW
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:7033 E TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1262
Mailing Address - Country:US
Mailing Address - Phone:907-729-5072
Mailing Address - Fax:
Practice Address - Street 1:999 E TUDOR RD STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6123
Practice Address - Country:US
Practice Address - Phone:907-729-8961
Practice Address - Fax:907-729-5180
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 13252101YP2500X
NMCTB-2022-0272101YP2500X
AK115272101YP2500X
CA11503101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK115272OtherLPC
AK1724389Medicaid
CA11503OtherLPCC
NM20220272OtherLPCC
AZ13252OtherLPC