Healthcare Provider Details

I. General information

NPI: 1992624597
Provider Name (Legal Business Name): AMANDA MICHELE EMBRY LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2293 GLENBAR DR
GERMANTOWN TN
38139-5417
US

IV. Provider business mailing address

2293 GLENBAR DR
GERMANTOWN TN
38139-5417
US

V. Phone/Fax

Practice location:
  • Phone: 913-271-3358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5551
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: