Healthcare Provider Details
I. General information
NPI: 1306208947
Provider Name (Legal Business Name): AMY HUFFMAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2016
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 E MAIN DR STE 220
EL PASO TX
79901-1357
US
IV. Provider business mailing address
1605 GEORGE DIETER DR STE 636
EL PASO TX
79936-5600
US
V. Phone/Fax
- Phone: 915-910-2060
- Fax:
- Phone: 915-671-1371
- Fax: 915-219-9022
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 86131 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | CCMH0196781 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: