Healthcare Provider Details

I. General information

NPI: 1386366458
Provider Name (Legal Business Name): AMANDA D HALL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 E 9TH AVE
WINFIELD KS
67156-2817
US

IV. Provider business mailing address

207 E 9TH AVE
WINFIELD KS
67156-2817
US

V. Phone/Fax

Practice location:
  • Phone: 620-719-8229
  • Fax: 620-229-8124
Mailing address:
  • Phone: 620-719-8229
  • Fax: 620-229-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT03448
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: