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General NPI Number Information
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NPI Number | 1386038180
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Entity Type | Individual
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Provider Name | AMANDA LA GUARDIA PHD, LPCC-S, NCC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 48 E HOLLISTER ST
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City | CINCINNATI
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State | OH
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Zip | 45219-1704
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Country | US
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Telephone | 513-556-8462
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 MCMICKEN CIRCLE
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City | CINCINNATI
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State | OH
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Zip | 45221-0001
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Country | US
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Telephone | 423-676-2298
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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 | E.1600038-SUPV
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License Number State | OH
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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 | 67303
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License Number State | TX
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