Provider Demographics
NPI:1982364840
Name:AMITRANO, JAMIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:AMITRANO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 CHURCH ST STE 216
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3881
Mailing Address - Country:US
Mailing Address - Phone:630-797-9871
Mailing Address - Fax:
Practice Address - Street 1:708 CHURCH ST STE 216
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3881
Practice Address - Country:US
Practice Address - Phone:630-797-9871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
166.001728106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist