Healthcare Provider Details

I. General information

NPI: 1568372589
Provider Name (Legal Business Name): AMANDA AGUILERA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 INDIANA ST
ARVADA CO
80007-7578
US

IV. Provider business mailing address

6700 INDIANA ST
ARVADA CO
80007-7578
US

V. Phone/Fax

Practice location:
  • Phone: 720-938-8715
  • Fax:
Mailing address:
  • Phone: 720-938-8715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC.0024500
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: