Healthcare Provider Details

I. General information

NPI: 1508258096
Provider Name (Legal Business Name): AMANDA TAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 RIO GRANDE ST SUITE 200
AUSTIN TX
78701-1124
US

IV. Provider business mailing address

1700 RIO GRANDE ST STE 200
AUSTIN TX
78701-1638
US

V. Phone/Fax

Practice location:
  • Phone: 512-732-8400
  • Fax: 512-732-8353
Mailing address:
  • Phone: 512-732-8400
  • Fax: 512-732-8353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number71230
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17650
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number71230
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1982
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: