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General NPI Number Information
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NPI Number | 1194337766
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Entity Type | Individual
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Provider Name | AMANDA LAI WAI KUEN MA, NCC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 2500 W HIGGINS RD STE 260
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-2042
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Country | US
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Telephone | 224-801-1779
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 E LAKE COOK RD FL 9
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1862
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Country | US
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Telephone | 224-801-1779
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.016096
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License Number State | IL
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