Healthcare Provider Details

I. General information

NPI: 1255294617
Provider Name (Legal Business Name): AMANDA LYNN CARTER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 SAFE HARBOR WAY
RENO NV
89512-1137
US

IV. Provider business mailing address

6060 INGLESTON DR UNIT 1213
SPARKS NV
89436-7080
US

V. Phone/Fax

Practice location:
  • Phone: 775-787-9411
  • Fax:
Mailing address:
  • Phone: 775-240-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number08173-I
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: