Provider Demographics
NPI:1548970890
Name:HARVEY, AMANDA (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CONCORD CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-9061
Mailing Address - Country:US
Mailing Address - Phone:512-689-3003
Mailing Address - Fax:
Practice Address - Street 1:8700 MENCHACA RD STE 804
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5379
Practice Address - Country:US
Practice Address - Phone:512-270-1489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83710101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor