Healthcare Provider Details

I. General information

NPI: 1649756131
Provider Name (Legal Business Name): AMANDA LEE ROLAND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA BACHMAN

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 S COUNTY ROAD 23
BERTHOUD CO
80513-9508
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 970-599-1144
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax: 303-617-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0016396
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: