Provider Demographics
NPI:1174372866
Name:BANDY, AMY ELIZABETH (LPC, NCC, NCSC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:BANDY
Suffix:
Gender:F
Credentials:LPC, NCC, NCSC
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LANDRENEAU
Other - Last Name:BANDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, NCC, NCSC
Mailing Address - Street 1:2468 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-4733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1515 HIGHWAY 1153
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-4523
Practice Address - Country:US
Practice Address - Phone:318-335-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4824101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty