Healthcare Provider Details

I. General information

NPI: 1760310619
Provider Name (Legal Business Name): AMANDA JEAN KIPFER MA, CRC, LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 PILCHUCK PL
FOX ISLAND WA
98333-9675
US

IV. Provider business mailing address

1203 PILCHUCK PL
FOX ISLAND WA
98333-9675
US

V. Phone/Fax

Practice location:
  • Phone: 360-271-9437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00097858
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC70064386
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: