Healthcare Provider Details

I. General information

NPI: 1316597040
Provider Name (Legal Business Name): AMANDA SAUVILLER MS, LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2019
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E MEMORIAL RD STE B-2/B-3
OKLAHOMA CITY OK
73114-2229
US

IV. Provider business mailing address

1601 S POTTAWATOMIE RD
HARRAH OK
73045-5933
US

V. Phone/Fax

Practice location:
  • Phone: 405-388-2339
  • Fax:
Mailing address:
  • Phone: 405-388-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10671
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10671
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10671
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: