Healthcare Provider Details

I. General information

NPI: 1457501413
Provider Name (Legal Business Name): AMANDA CHRISTINE VOILS-LEVENDA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 BARDSTOWN RD SUITE #BL
LOUISVILLE KY
40205
US

IV. Provider business mailing address

1911 BARDSTOWN RD SUITE #BL
LOUISVILLE KY
40205-1552
US

V. Phone/Fax

Practice location:
  • Phone: 812-318-6103
  • Fax:
Mailing address:
  • Phone: 812-318-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number20042731A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number167795
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: