Healthcare Provider Details

I. General information

NPI: 1225321532
Provider Name (Legal Business Name): AMANDA MAE MASON LPCC, LCADC, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA MAE CARPENTER

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 E MAIN ST
LEXINGTON KY
40508-2342
US

IV. Provider business mailing address

3359 COLDSTREAM DR
LEXINGTON KY
40517-2860
US

V. Phone/Fax

Practice location:
  • Phone: 859-608-3917
  • Fax: 859-407-2239
Mailing address:
  • Phone: 859-608-3917
  • Fax: 859-407-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number165010
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number309807
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number309807
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: