Provider Demographics
NPI:1912412388
Name:AMANDA ROBINSON LLC
Entity Type:Organization
Organization Name:AMANDA ROBINSON LLC
Other - Org Name:AMANDA ROBINSON LPC RPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:325-280-6261
Mailing Address - Street 1:1301 S CAPITAL OF TEXAS HWY STE C100
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6589
Mailing Address - Country:US
Mailing Address - Phone:512-790-3581
Mailing Address - Fax:
Practice Address - Street 1:1301 S CAPITAL OF TEXAS HWY STE C100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6589
Practice Address - Country:US
Practice Address - Phone:512-790-3581
Practice Address - Fax:512-790-3581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72877261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health