Provider Demographics
NPI:1912691775
Name:TINDELL, AMANDA MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MICHELLE
Last Name:TINDELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MICHELLE
Other - Last Name:TINDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMANDA HICKMAN
Mailing Address - Street 1:1215 E AVENUE M
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-4000
Mailing Address - Country:US
Mailing Address - Phone:254-654-5358
Mailing Address - Fax:
Practice Address - Street 1:1103 W. STAN SCHLUETER LP
Practice Address - Street 2:BUILDING A SUITE 100
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549
Practice Address - Country:US
Practice Address - Phone:254-213-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104693101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional