Healthcare Provider Details

I. General information

NPI: 1710394390
Provider Name (Legal Business Name): AMANDA PRICE LIMHP, LMHP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MANDY WATTS LIMHP LMHP LPC

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W 4TH ST STE 2
CHADRON NE
69337-2270
US

IV. Provider business mailing address

1720 CENTENNIAL DR
CHADRON NE
69337-9518
US

V. Phone/Fax

Practice location:
  • Phone: 308-430-1944
  • Fax: 775-667-6079
Mailing address:
  • Phone: 308-430-1944
  • Fax: 775-667-6079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: