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General NPI Number Information
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NPI Number | 1053836841
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Entity Type | Individual
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Provider Name | AMANDA MARIE YAMAMOTO LPC, ACD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 6909 S HOLLY CIR STE 304
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City | CENTENNIAL
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State | CO
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Zip | 80112-1045
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Country | US
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Telephone | 720-295-1599
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Fax |
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Provider Business Mailing Address
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Address Line | 10597 ASHFIELD ST
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-8071
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Country | US
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Telephone | 305-710-4007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0001480
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0016491
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License Number State | CO
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