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General NPI Number Information
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NPI Number | 1124483102
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Entity Type | Individual
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Provider Name | AMANDA BLAIR ED.S., LPC, SPS,NCSP
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Gender | Female
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 2800 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7236
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Country | US
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Telephone | 870-501-5060
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Fax | 870-501-5060
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Provider Business Mailing Address
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Address Line | 4504 ANTOSH CIR UNIT 2
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City | JONESBORO
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State | AR
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Zip | 72404-8687
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Country | US
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Telephone | 870-501-5060
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Fax | 870-501-5060
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1602016
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | P1602016
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10051133
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License Number State | AR
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